The Intersection of Weight Loss and Aesthetic Changes: Exploring the New Trends in Aesthetic Medicine

 The pursuit of weight loss, whether through rigorous diet, exercise, or medical intervention, has long been seen as an achievement of health and self-improvement. However, as modern weight management strategies become increasingly effective, many individuals are encountering an unintended consequence—significant changes in their physical appearance, particularly in the facial region. This phenomenon, often referred to as "Ozempic Face," has garnered attention in recent years as more people seek rapid weight loss through medications like GLP-1 receptor agonists (such as Ozempic and Mounjaro) or undergo bariatric surgery. While these treatments can be life-changing for many, they often lead to the accelerated depletion of facial volume, creating new challenges in aesthetic medicine.

The link between weight loss and aesthetic shifts is not merely a result of ageing, but rather a distinct set of changes that are catalyzed by the rapid reduction of body fat. When patients lose weight too quickly, especially in the face, the result is often an aesthetic imbalance: the skin can sag, the face may look hollowed or gaunt, and the natural contours of youth are lost. This issue has caused a growing number of patients to seek treatment from professionals, as they aim to restore both volume and a youthful appearance that may have been compromised by their weight loss.

Facial volume loss due to rapid weight reduction is fundamentally different from the changes that occur due to the natural process of ageing. While both processes involve changes in the face’s fat distribution, the mechanisms differ greatly. Age-related volume loss is slow and gradual, affecting not only the subcutaneous fat pads but also the skin and underlying bone. Over time, bone resorption occurs, and the skin's elasticity diminishes. By contrast, the accelerated fat loss caused by rapid weight reduction often does not allow the bone and skin to adjust in a similar manner, creating an imbalanced deflation effect. The once plump and youthful contours of the face may become more hollow, sagging in a way that often appears unnatural.

Dr. Ash Soni, a UK and US-trained plastic surgeon, is familiar with this shift in aesthetic concerns. He explains that, “The facial changes we are seeing from patients that are on GLP-1 drugs, and especially those that have undergone rapid weight loss, is a reduction in volume and the fat pads are changing. They are decreasing the amount of fat in the volume of the face, and as a result of that, decreasing volume, there is a lack of elasticity, sagging of the tissue, and dropping of facial structure.” As a result, these patients may notice a more aged appearance and less skin bounce, akin to the signs of natural ageing. This presents a challenge for doctors and patients alike, as the typical volume-restoring treatments may not suffice.

A significant portion of patients who experience rapid weight loss and the subsequent volume depletion are also entering other life stages, such as perimenopause or menopause. As Dr. Glyn Estebanez, the medical director and founder of Dr. Glyn Medispa, explains, “The growing use of GLP-1 medications like Ozempic and Mounjaro is leading to a really significant rise in patients presenting to me with concerns around facial volume loss and laxity. Many of these patients are also in their 40s or 50s and entering perimenopause or menopause, which brings its own set of changes to skin, fat distribution, collagen loss and overall facial structure.” This means that these patients are not only facing volume loss due to their weight loss efforts but also experiencing the natural effects of hormonal changes on their skin. The combination of both factors can exacerbate the issue, resulting in a more pronounced appearance of facial deflation.

The mid-face area, in particular, is one of the first regions to show the signs of this type of volume loss. The cheeks, which contribute to the facial structure and youthful appearance, can flatten, and the fat pads that define the natural contours of the face may descend, leading to a hollowed look, especially under the eyes. Dr. Estebanez comments, “We typically see a reduction in volume across the cheeks, leading to a flattening of natural contours, descent of facial fat pads, and hollowing of the under-eye region.” This flattening of the cheeks and descent of fat pads are the telltale signs of facial volume depletion caused by rapid weight loss.

Interestingly, many patients express a desire to address these concerns through non-invasive methods. In fact, research conducted by Professor Syed Haq on behalf of IMAGE Skincare corroborates the clinical observations of doctors. According to Haq, “From our research, we found that the number one concern from GLP-1 users is loose and sagging skin. Secondary to this was firming and tightening. In conjunction, both of these reflect a strong focus on addressing skin laxity. Hydration was also highly valued, highlighting its importance alongside firming benefits.” As patients seek solutions to these concerns, a new wave of aesthetic treatments is emerging, designed specifically for this population.

One such treatment is biostimulation with poly-L-lactic acid (PLLA), marketed as Sculptra. Sculptra is gaining traction as a highly effective method for restoring facial volume lost due to rapid weight loss. PLLA works by stimulating the production of collagen in the skin over a series of treatments, gradually rebuilding the facial structure and restoring natural volume. A pivotal study evaluating PLLA for cheek wrinkles demonstrated its safety and effectiveness, with over 71% of participants showing significant improvement at 12 months. Not only does this treatment restore volume, but it also improves skin radiance, tightness, and overall contour.

What makes Sculptra especially compelling is its ability to stimulate the formation of both collagen and adipose tissue. While it was traditionally believed that PLLA primarily targeted the dermis to stimulate collagen, a 2024 split-body clinical trial uncovered a more sophisticated mechanism: PLLA may also promote adipogenesis, or the formation of new fat cells, in the subcutaneous layer. This discovery is groundbreaking because it suggests that PLLA can help restore the very adipose tissue lost during weight reduction, offering a foundational solution for patients seeking to regain their youthful facial volume.

Dr. Soni explains, “Sculptra’s effect on Type One collagen is that it’s increasing it by 67% in 12 weeks so patients get a surge in Type One collagen and improved elasticity, which is helping patients as their faces are starting to drop. It’s also stimulating those youthful adipocytes, which are the fat cells that change in structure as we age – creating a lovely bounce back to the skin and, especially in those that have lost fat & volume quickly, restoring natural volume to the face and a real improvement in terms of skin quality.” This dual-action approach—stimulating both collagen production and fat cell rejuvenation—makes Sculptra an ideal treatment for patients suffering from rapid volume depletion.

In addition to biostimulators like Sculptra, another popular treatment for immediate volume restoration is hyaluronic acid (HA) fillers, such as Juvéderm. These products offer quick and visible results, making them a valuable option for patients seeking a more immediate solution to their facial volume loss. HA fillers are particularly effective in correcting specific areas of volume depletion, such as the cheeks, temples, and jawline, and they provide a more immediate aesthetic improvement. However, they do not offer the long-term structural benefits that biostimulators like Sculptra provide.

Dr. Estebanez combines both approaches for optimal results. “For patients looking to address this, I use a multi-layered approach. Products like Juvéderm VOLUMA help rebuild the foundational structure of the mid-face and restore support without distortion. This perfectly complements HArmonyCa as a go-to for patients needing both collagen stimulation and additional tightness, to enhance long-term skin strength and quality.” By strategically combining HA fillers and biostimulators, clinicians are able to address both the immediate and long-term concerns associated with rapid weight loss and volume depletion.

Furthermore, advancements in topical treatments are providing patients with additional tools to manage their skin health at home. VOL.U.LIFT, a product developed by Image Skincare, is specifically designed to address the skin changes associated with GLP-1-induced weight loss. VOL.U.LIFT combines ingredients like L-ornithine amino acid, which activates adipogenesis and promotes a fuller look, and bakuchiol, a plant-based alternative to retinol that stimulates collagen production and improves skin texture. Early clinical trials have shown that VOL.U.LIFT can significantly improve facial skin thickness and volume, making it an effective adjunct to in-clinic treatments.

The integration of topical solutions like VOL.U.LIFT into a patient’s skincare routine can enhance the overall results of in-office treatments, supporting hydration, firmness, and skin elasticity. As the aesthetic industry continues to evolve, it is clear that a multi-layered, personalized approach to volume restoration and skin rejuvenation is the most effective solution for patients experiencing the effects of rapid weight loss.

Ultimately, managing post-weight loss facial volume depletion is not a one-size-fits-all process. Successful treatments require a holistic, multi-pronged approach that combines advanced in-clinic procedures like biostimulators and HA fillers with at-home skincare solutions to address both immediate and long-term concerns. As the demand for these treatments grows, it is essential for clinicians to develop personalized plans tailored to each patient’s unique needs, ensuring that their aesthetic goals are met while maintaining a natural and balanced appearance.