OZEMPIC FACE
Season 1, Episode 9
This new article from Dr. Shauly and his research team, a systematic review from Aesthetic Surgery Journal Open Forum, explores the implications of GLP-1 receptor agonists, commonly known as drugs such as Ozempic, in plastic surgery. It details how these weight-loss medications can lead to significant facial and body changes, such as the phenomenon termed "Ozempic Face," characterized by accelerated volume loss and signs of aging. The review also examines public perception of these effects through Google Trends analysis, revealing a growing interest in cosmetic procedures like fillers and plastic surgery to address these changes. Finally, it provides guidance for plastic surgeons on patient counseling, perioperative management, and available surgical and non-surgical interventions for patients using these medications.
Comprehensive Study Guide
Short Answer Questions
Instructions: Please answer the following questions in 2-3 sentences each.
What is "Ozempic Face" and what causes it?
Name three GLP-1 receptor agonists mentioned in the article and their marketed names.
What is the primary difference in FDA approval between Ozempic/Mounjaro and Wegovy/Saxenda/Zepbound?
Besides facial changes, what other morphological changes can GLP-1 receptor agonists cause, and what terms are used to describe them?
What are some nonsurgical options available to address "Ozempic Face"?
What are some surgical options available to address the effects of GLP-1 receptor agonist-mediated weight loss on the face and body?
Why are gastrointestinal side effects of GLP-1 receptor agonists particularly concerning for patients undergoing elective surgery?
What are the main contraindications for the use of GLP-1 receptor agonists?
How has public interest in "Ozempic Face" influenced searches for aesthetic procedures?
What is the paper's overall conclusion regarding the term "Ozempic Face" and its impact on the plastic surgery community?
Short Answer Key
"Ozempic Face" describes the exaggerated volume loss, particularly in the face, resulting from semaglutide therapy and other GLP-1 receptor agonists. This rapid weight loss can lead to a gaunt appearance resembling advanced facial aging due to the reduction of adipose tissue without compensatory collagen remodeling.
Three GLP-1 receptor agonists and their marketed names are: semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), and liraglutide (Saxenda).
Wegovy, Saxenda, and Zepbound are FDA-approved for chronic weight management. In contrast, Ozempic and Mounjaro are only FDA-approved for patients with Type 2 diabetes, meaning their use for weight loss is considered off-label.
Besides facial changes, GLP-1 receptor agonists can lead to similar changes in breast, body, and buttock morphology. These are popularized by terms such as "Ozempic Body" and "Ozempic Butt," reflecting the loss of tissue volume in these areas.
Nonsurgical options for "Ozempic Face" include injectable dermal fillers (like hyaluronic acid, calcium hydroxyapatite, poly-L-lactic acid, polymethylmethacrylate, or autologous fat transfer), collagen stimulators, and skin-tightening techniques such as radiofrequency microneedling or CO2 laser therapy.
Surgical options for the face include face and neck lift surgeries, which address excess skin, and facial fat grafting to restore lost volume. For the body, procedures like mastopexy (breast lift), panniculectomy, abdominoplasty (tummy tuck), brachioplasty (arm lift), and thighplasty are used to address excess skin and laxity.
Gastrointestinal side effects such as delayed gastric emptying increase the risk of vomiting and aspiration during intubation for surgery. This concern has led to the development of specific holding protocols and guidelines by organizations like the American Society of Anesthesiologists (ASA) to mitigate these risks.
GLP-1 receptor agonists are contraindicated in patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2), due to a potential risk identified in preclinical studies. Caution is also advised for patients with previous hypersensitivity to these medications.
Public interest in "Ozempic Face" has led to coincidentally rising searches for "face filler" and "plastic surgeons." This indicates a growing public demand for rejuvenation procedures as awareness of these unintended morphological changes becomes more widespread.
The paper concludes that "Ozempic Face" likely represents a transient trend coined by the public and news outlets rather than entirely new medical terminology or a unique side effect. It emphasizes that plastic surgeons are well-equipped to manage these changes, which are a direct consequence of rapid adipose tissue loss, and that the term highlights a rising need for aesthetic interventions.
Key Terms
Adipose Tissue: Body fat, which can be lost rapidly with GLP-1 receptor agonist use, contributing to volume loss in the face and body.
Aesthetic Surgery: A branch of plastic surgery focused on improving appearance through surgical and nonsurgical procedures.
ASA: A professional organization that issues guidelines, including those for managing patients on GLP-1 receptor agonists during the perioperative period to mitigate risks like aspiration.
Autologous Fat Transfer: A surgical procedure where fat is harvested from one part of the body and injected into another area to restore volume.
Body Mass Index (BMI): A measure used to classify obesity and assess surgical candidacy, calculated as weight in kilograms divided by the square of height in meters.
Collagen: A protein that provides structural support to the skin; its remodeling or reduction can contribute to skin laxity and signs of aging.
Contraindications: Specific conditions or factors that make a particular treatment or medication inadvisable due to potential harm.
Dermal Fillers: Injectable substances, such as hyaluronic acid, used to restore volume, smooth wrinkles, and enhance facial contours.
Delayed Gastric Emptying: A common gastrointestinal side effect of GLP-1 receptor agonists, where food remains in the stomach for an extended period, increasing aspiration risk during surgery.
Elastin: A protein in the skin that allows it to stretch and return to its original shape; decreased levels can contribute to sagging.
FDA Approval: Official authorization by the U.S. Food and Drug Administration for a drug or device to be marketed for a specific use.
Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists: A class of medications, including semaglutide and tirzepatide, that stimulate insulin secretion and have demonstrated significant weight-loss potential.
Hyaluronic Acid: A common type of dermal filler used to add volume and hydration to the skin.
Medullary Thyroid Carcinoma: A rare type of thyroid cancer; GLP-1 receptor agonists are contraindicated in patients with a history of this cancer due to preclinical study associations.
Morphological Changes: Alterations in the form, structure, or shape of the body or its parts, such as those seen in "Ozempic Face" or "Ozempic Body."
Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2): A genetic disorder associated with an increased risk of certain endocrine tumors, including medullary thyroid carcinoma, making GLP-1 receptor agonists contraindicated.
Off-Label Use: Prescribing a medication for a condition or in a manner not specified in its FDA-approved labeling.
"Ozempic Body": A public term referring to the generalized loss of tissue volume and associated skin laxity in the body (e.g., breasts, abdomen, extremities) due to GLP-1 receptor agonist-mediated weight loss.
"Ozempic Butt": A public term specifically referring to the loss of tissue volume in the buttock region due to GLP-1 receptor agonist-mediated weight loss.
"Ozempic Face": A public term coined to describe the exaggerated facial volume loss and gaunt appearance resembling advanced aging, resulting from rapid weight loss induced by GLP-1 receptor agonists like semaglutide.
Pannus/Panniculectomy: A pannus is an apron of excess skin and fat, often found in the lower abdomen after significant weight loss. A panniculectomy is a surgical procedure to remove this excess tissue.
Perioperative Management: The care provided to a patient before, during, and after surgery, including considerations for medication use and risk mitigation.
Plastic Surgery: A surgical specialty concerned with the restoration, reconstruction, or improvement of the body's form and function, encompassing both reconstructive and aesthetic procedures.
Ptosis/Ptotic: Drooping or sagging, often referring to skin or tissues, such as "ptotic pannus" or breast deflation.
Semaglutide: A specific GLP-1 receptor agonist marketed as Ozempic (for Type 2 diabetes) and Wegovy (for chronic weight management).
Systematic Review: A type of literature review that collects and critically appraises all available research on a specific topic using rigorous, predefined methods.
Tirzepatide: A medication that activates both GLP-1 and glucose-dependent insulinotropic polypeptide receptors, marketed as Mounjaro (for Type 2 diabetes) and Zepbound (for chronic weight management).
Volume Loss: The reduction of fat or soft tissue, often associated with weight loss, leading to a sunken or hollowed appearance, particularly in the face.
Weight Regain: The tendency for patients to regain a significant portion of lost weight after discontinuing GLP-1 receptor agonists, highlighting the need for long-term use.
