While operating on Ozempic patients, Dr. Few began to notice a trend: The quality of someone’s skin with GLP-1 reminded them of an “old, overused rubber.” Mark MofidMD, a board-certified facial plastic surgeon in San Diego and La Jolla, makes a similar comparison—it’s like the elastic band on a pair of underwear that has stretched over time.
Dr. Diamond, who specializes in facelift surgery, has observed that the SMAS layer is “definitely thinner and weaker” in people using GLP-1 for weight loss. (SMAS is an acronym for subcutaneous musculoaponeurotic system, a layer of connective tissue that supports the face.) Typically, the SMAS naturally thins as you age, which can contribute to facial aging, such as sagging around the cheeks, according to with study was published on Journal of Cosmetic Surgery Open Forum. And if an Ozempic patient has plans to become a facelift patient, it’s worth noting that the SMAS layer is also essential for natural results. “Lifting success is really based on the strength of the muscle layer,” says Dr. Diamond. “You don’t take the skin off and use it to lift. Thin muscle layer can definitely affect lifting results.”
Dr. Few estimates that about 25 to 30 percent of his patients are currently taking GLP-1 and finds that their skin “doesn’t hold its elastic recoil like it did.” Based on his experience, using a GLP-1 “seems to almost age the quality of the skin, like the skin takes on the appearance of an older person.” It has seen skin look more worn and lose its ability to hold its shape around facial structures, which can lead to sagging around the jawline, for example. These are changes he hasn’t seen in patients who have lost significant weight in other ways—such as through diet or gastric bypass surgery—that make him think it’s unique to using GLP-1.
We asked Novo Nordisk, the makers of Ozempic and Wegovy, about what some plastic surgeons are noticing, and they sent us the following comment: “At Novo Nordisk, patient safety is a top priority. We work closely with the US Food and Drug Administration to continuously monitor the safety profile of our drugs. We are not aware of any studies looking at the effect of semaglutide specifically on facial fat. We recommend that any patient who experiences side effects while taking Wegovy or Ozempic contact their healthcare provider.” Novo Nordisk also noted that, “although Wegovy and Ozempic both contain semaglutide, they are different products with different indications, dosages, prescribing information, titration schedules and forms of administration. The products are not interchangeable and should not be used outside of their approved indications. Novo Nordisk is committed to the responsible use of our medicines. We take many steps to ensure the responsible use of our semaglutide medicines, which are detailed semaglutide.com.” Those approved indications, they continued, are as follows: “Wegovy 2.4 mg is FDA-approved in combination with a reduced-calorie diet and increased physical activity to reduce the risk of major cardiovascular events such as death, heart attack, and stroke in adults with known heart disease and either obesity or overweight. and to help obese adults and children ≥ 12 years of age or certain overweight adults with weight-related medical problems lose excess body weight and keep it off. Ozempic is FDA-approved to treat type 2 diabetes, to improve blood sugar, along with diet and exercise, and reduce the risk of serious cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes and known heart disease. Ozempic is not approved for chronic weight management.
Where they see it
You’ve probably heard of the “Ozep face,” a term for the sunken look that can result from rapid weight loss. In her practice, Ubarin Mahmuda board-certified plastic surgeon in New York City, observed “accelerated facial aging” in patients who lost significant weight on a GLP-1, noting “increased fine lines, freckles, periorbital hollowing, and skin laxity.” But skin changes appear also in the arms, legs, and stomach. Dr. Mahmood has seen “significant increased laxity in the tissue of the breasts, abdomen, arms, and inner thighs.” [the part of the thigh that includes the hips]in patients who received GLP-1 to lose weight. In response, Dr. Mahmood has turned to tools like the Galaflex mesh bra, often referred to as an “inner bra,” when performing a breast lift or lift with implants. “The elasticity of the skin weakens and it needs additional support to hold an implant or maintain a new shape on its own,” he says.
