Illustration by The Epoch Times, Shutterstock

It’s been decades since Carole Maggio first started teaching her spa clients to exercise their faces to reverse signs of aging.

Today, GLP-1 receptor agonists are edging out sun damage as the driver factor for facial exercises, which she calls “facercise.” She’s seeing more patients taking these weight-loss drugs in her spa with the telltale signs of “Ozempic face,” such as sagging skin, sunken cheeks and eyes, and deeper wrinkles.

She recounted how many people have said they just wanted to lose 10 pounds, but they lost 30.

“They get on this roll and in their mind’s eye, they think more is better. They end up looking so much older,” Maggio told The Epoch Times.

“Ozempic face” can be prevented with a slower approach to weight loss, experts say.

There are also non-invasive tools—holistic approaches like Maggio’s and fillers of many kinds—that can prevent and reverse saggy skin.What Causes ‘Ozempic Face’?Patients taking GLP-1 receptor agonists lose an average of 7 percent of their facial volume for every 22 pounds lost, mostly from fat pads in the midface—cheeks and areas around the nose, mouth, and temples, according to a study published in Otolaryngology—Head and Neck Surgery quantifying the “Ozempic face” phenomenon. Fat volume helps make a face look youthful.  Related Stories

A mixture of factors influences facial changes, including the potential rapid loss of nutrients, vitamins, and fatty acids that make up the building blocks of collagen and elastin, which act as a scaffolding of sorts for facial firmness. GLP-1 drugs can also disrupt the skin barrier and cause dry, dull skin.

The authors noted that clinical trials analyzing GLP-1 receptor agonist use for weight loss rarely report facial fat loss as an adverse effect.

“Because of this, providers prescribing these medications are unlikely to counsel patients pretreatment about the potential for undesirable changes in facial appearance.”How to Recognize ‘Ozempic Face’Ozempic face can have a global effect on the face, according to plastic surgeon Dr. John Burns. He provided a more detailed explanation of some changes that could take place:

Increased lines and wrinkles around the eyes, forehead, and mouth

Sunken or hollowed eyes

Hollow cheeks or temples

Sagging, loose skin along the jawline and jowls

Exaggerated nasolabial folds and marionette lines

Thinner lips, elongated upper lip

More visible facial bones, loss of fullness or plumpness

Unmasking of the platysma muscle in the lower face and neck

New Name–Persistent IssueHollowed-out faces accentuated by wrinkles and sagging isn’t new—the condition only has a new name due to its rising prevalence in tandem with GLP-1 drug use, said dermatologist Brooke Jeffy.

“You see the exact same changes in someone who loses weight rapidly from other things, like bariatric surgery, for example,” she told The Epoch Times.

Ozempic face tracks with a universal phenomenon—aging. “As we age, we lose collagen and elastin in our skin, and then when you add on top of that a loss of facial fat and a loss of muscle tone, the combination is profound,” Burns said. “The amount of weight loss is important. If somebody’s lost 20 pounds, that’s one thing, but if they’ve lost a hundred pounds, that’s a whole other thing.”‘Ozempic Face’ TreatmentsThere is a wide variety of approaches from non-invasive to plastic surgery that address “Ozempic face.” Here are a few:Facial WorkoutsMaggio coaches clients in 13 exercises that amount to a daily commitment of 14 minutes.The workout is designed to combat the seven signs of aging—also common in those experiencing ‘Ozempic face’— including low eyebrows, drooping eyelids, nose faults, sagging jaw, double chin, thin lips, and low, flat cheeks. By using your fingers as counterweights and working facial muscles until you feel a lactic acid burn, the routine she teaches aims to lift and tone facial features.Some exercises include:

Cheek lift: Exercises the buccinator muscle, lifting it and helping add dimension to the face

Eye opening: Contracts the orbicularis oculi and levator palpebrae superiors, muscles that create sleepy eyes when they’re relaxed and loose

Lip toner: Involves all mouth muscles to smooth lip lines and plump the lips

Lip corners up: Lifts the corners of the mouth

Facial exercises won’t help with fat loss, but they may prevent muscle wasting. Burns said toning your face could also help build muscle volume.“I do think animating your face, using those muscles more vigorously, would help.”FillersFor those looking for a more rapid transformation, a wide variety of injectable procedures can restore facial volume in a number of ways.

Synthetic fillers can be either short-lived, lasting six to 18 months, or bio-stimulating, which causes your body to create collagen and scar tissue, and last two to three years, or even longer, according to plastic surgeon Dr. Robert Bonillas.

Common fillers include:

Hyaluronic acid: a substance found in the skin that keeps it plump and hydrated. It can be injected as a gel for results that last six to 12 months.

Calcium hydroxylapatite: found primarily in the bones, it is thicker than hyaluronic acid and lasts up to 12 months.

Polymethylmethacrylate: a synthetic, biocompatible substance like poly-L-lactic acid, but takes the form of a tiny ball beneath the skin. It provides support indefinitely and also contains collagen.

Poly-L-lactic Acid A biodegradable synthetic substance, poly-L-lactic acid, is biocompatible, which means it’s safe to use in the body. One of its main mechanisms is that it stimulates your body to rebuild natural collagen, and the gel itself is absorbed after a few days, much like absorbable stitches. It’s sold under the brand name Sculptra® Aesthetic.Unlike fillers that tend to dissipate quickly, biostimulating products recruit your own body to make more collagen, which leads to a longer-lasting effect. The poly-L-lactic acid itself is often undetectable in six to eight weeks, replaced by tissue your body has made.Autologous Fat InjectionsOn the more invasive end of the spectrum, autologous fat injections require surgery but have longer-lasting results of many years. Liposuction is used to collect fat from another area of your body—it’s then purified and injected into the temples, cheeks, lower eyelids, and other areas.

“These work pretty well unless patients undergo a significant or a severe amount of weight loss, where they have significant wasting, and then because fat behaves like fat, it will eventually resorb with further weight loss,” Bonillas told The Epoch Times.

Fillers can be more advantageous for those who are still losing weight or whose weight isn’t stabilized, he added.

Most facelifts involve fat injections or fillers because facelifts alone don’t address the loss of volume, they simply tighten loose skin. It can be helpful for your weight to be stabilized before opting for a more invasive surgery.

Facelifts can also be a wake-up call for patients to make healthier choices to protect their investment, Jeffy said.

“If you want to keep it, you have to take care of it,” she said. “Living a healthy life is not necessarily easy. We have to make harder choices sometimes.”Healthy Life, Healthy FaceSince “Ozempic face” can result from the rapid depletion of nutrients, vitamins, and fatty acids that help maintain collagen and elastin, an alert in Facial Plastic Surgery recommends reducing the risk by prioritizing a nutrient-rich diet with ample protein, vitamin C, antioxidants, and mineral-rich foods.

To prevent premature aging, experts advised avoiding excessive sun exposure and cigarette smoking, while drinking plenty of water, exercising, and eating whole, nutrient-dense foods.

Avoiding packaged food with preservatives should become a lifestyle, Burns said. “Diet sodas are not good for you. Sugary drinks are not good for you. The healthier you are, the better your skin is going to look, and the better it will hold up to weight loss.”

Maggio added that a good skin care routine with gentle cleansing and products that exfoliate and contain retinol, which can stimulate collagen production, can be helpful, too. She also advises that her clients address stress and sleep deprivation—both of which can age the face.

Experts said the only way you might prevent Ozempic face is to slow down the rate and amount of weight loss. However, there’s no good way to predict how your face might react to weight loss.

“I’ve always believed personally that there’s a healthy way to lose weight,” Burns said. “The GLP-1 medications help people get past barriers, but in general, you want to get to a point where you can maintain your healthy weight with a good diet and exercise program.”

We had a problem loading this article. Please enable javascript or use a different browser. If the issue persists, please visit our help center.