By Dr. Philip Solomon and Nancie Heiber
GLP-1 medications can produce significant weight loss, but the resulting loss of facial volume may leave some patients with hollow cheeks, loose skin, or diminished definition through the jawline and neck. Dr. Philip Solomon, MD, FRCSC, Otolaryngology, Head and Neck Surgeon practising Facial Plastic Surgery in Toronto, explains why these changes occur, who is most likely to experience them, and how treatments ranging from fat grafting to facelift surgery can help restore balance and structure to the face.
What are GLP-1 medications, and why have they become such a popular option for weight loss?
GLP-1 medications are a class of drugs that mimic a naturally occurring hormone called glucagon-like peptide-1, which is released by the intestines after we eat. They were originally developed to treat type 2 diabetes, but several are now approved for chronic weight management because of their effectiveness in helping patients lose weight. These medications work by reducing appetite, increasing feelings of fullness, slowing stomach emptying, and improving blood sugar regulation. Together, these effects help people consume fewer calories without experiencing the same degree of hunger that often makes traditional dieting difficult. For many patients, GLP-1 medications have been a game changer, producing significant weight loss while also improving overall health.
The term “Ozempic face” has been circulating online. What exactly is it, and why can some people appear older after significant weight loss?
“Ozempic face” is a popular, non-medical term used to describe the facial changes that can occur after rapid or significant weight loss, particularly among people taking GLP-1 medications such as Ozempic. The medication itself does not cause the face to age; rather, these changes result from the loss of facial fat that accompanies weight loss, whether achieved through GLP-1 medications, diet and exercise, or bariatric surgery. As facial fat decreases, several changes may become more noticeable, including sunken cheeks, skeletal cheekbones, hollowing at the temples, loose skin along the jawline and neck, deeper facial folds, and an overall thinner, more gaunt appearance. These changes can make someone appear older, even though they may be healthier overall. Because GLP-1 medications can lead to rapid and substantial weight loss in some patients, these facial effects may be quite pronounced.
Does everyone who loses a significant amount of weight experience these facial changes, or are some people more susceptible than others?
Not everyone who loses a significant amount of weight develops noticeable facial changes. While some degree of facial fat loss is common, the extent to which it affects a person’s appearance varies considerably. Age is one of the most significant factors. Younger patients generally have better skin elasticity because they have higher levels of collagen and elastin, allowing the skin to contract more effectively after weight loss. As we age, the skin naturally loses elasticity, making loose skin and wrinkles more noticeable. The amount and speed of weight loss also play important roles. Someone who loses 50 to 100 pounds is more likely to experience facial volume loss than someone who loses 15 or 20 pounds. Rapid weight loss can also make these changes appear dramatic because the skin has less time to contract.
Genetics influence how we age and where we naturally store facial fat, which is why two people who lose the same amount of weight can have very different facial outcomes.
After significant weight loss, how do you determine whether someone is a candidate for non-surgical treatments or a facelift, and what can a facelift achieve that those treatments cannot?
The first step is determining whether the primary concern is volume loss, skin laxity, or a combination of both. Non-surgical treatments can be effective for patients experiencing mild to moderate changes, such as early volume loss, fine lines, or minimal skin laxity. Dermal fillers, neuromodulators, biostimulators, and skin-tightening treatments can restore volume, improve skin quality, and enhance facial balance. A facelift may be the better option when there is moderate to severe loose skin in the lower face and neck, increased jowling, deeper facial folds, or a loss of jawline definition. At that point, non-surgical treatments can do only so much. They cannot reposition descended facial tissues or remove excess skin. One of the biggest misconceptions is that a facelift simply tightens the skin. A modern facelift repositions the deeper support structures of the face and removes excess skin to restore a more youthful jawline, neck contour, and overall facial proportions.
Are there any other procedures you would recommend to rejuvenate the face after weight loss?
Facial fat grafting can be a critical component of facial rejuvenation for patients who have experienced facial volume loss while taking GLP-1 medications. Fat grafting allows us to restore volume in key areas of the face, such as the cheeks, temples, and midface, creating greater balance, softness, and facial harmony. By using a patient’s own fat, we can enhance the results of a facelift. The most successful facial rejuvenation procedures address both structural descent and volume depletion, creating results that look refreshed, not overdone.
If someone is considering facelift surgery after significant weight loss, what advice would you give them before they take the next step?
The most important advice is to maintain a stable weight for several months before considering facial rejuvenation surgery. If you are still actively losing weight—whether through diet, bariatric surgery, or a GLP-1 medication such as Ozempic or Wegovy—you may continue to lose facial volume after surgery, which can affect the final result. Achieving a stable weight before surgery provides a more reliable foundation for long-term facial rejuvenation. Once a patient’s weight has stabilized, we can accurately assess areas of volume loss and tissue laxity, allowing for a more precise surgical plan. An additional consideration for patients undergoing facelift surgery while taking a GLP-1 medication is the need to temporarily discontinue the medication before surgery. For safety reasons, I typically advise patients to stop taking the medication approximately one week before surgery. It can generally be resumed two weeks after surgery, once early healing has progressed and normal nutrition and hydration have been re-established. Significant weight loss can be life-changing, and facial rejuvenation surgery may help patients feel that their appearance reflects the transformation they have achieved.
Aug 25th 2026
