January 2024

The Ozempic Facelift:
Rejuvenation After Weight Loss

The Ozempic Facelift

The rapid weight loss drugs Ozempic, semaglutide, and Wegovy have transformed the weight loss industry. This highly effective drug is well tolerated by most and results in dramatic weight loss in almost all cases. However, major weight loss comes with its own set of issues like loose skin and changes in skin tightness on the face and body. I'm seeing a lot of patients who are using Ozempic and now wish to address skin laxity at their neck and face. In my office we call this the Ozempic Facelift.

Characteristics Of A Youthful Face

Aging Face- Gravitational Descent

A youthful face exudes a distinctive roundness, underlined by its rich collagen content. This collagen lends the skin an inherent smoothness, diminishing the appearance of fine lines and wrinkles. The texture feels soft to the touch, reflecting hydration and elasticity. Together, these elements—softened contours, abundant collagen, a smooth skin surface, and a supple texture—compose the hallmark features of a face radiating youthful vitality.

Ozempic and other rapid weight loss medications are proving to accelerate facial and skin aging in general. The media and plastic surgery community have named the phenomenon Ozempic Face.

Read more about Ozempic Face here

Best Facelift Surgeon in the U.S.- Dr. John Burns, M.D., F.A.C.S.

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Research Facelift

What Is Ozempic Face?

The “Ozempic Face” is characterized by a lean or overly gaunt appearance, which is almost cachectic in appearance. The leanness is exacerbated with excess skin which appears to almost fall off the face. It's often most notable along the jawline and neck.

There's also volume loss, not merely from fat, due to loss of facial muscles as well. Where regular facelift patients need to address skin laxity and midface tissue descent, Ozempic Facelift patients present with:

  • more exaggerated temple hollowing
  • hollowness around the eyes (a sunken in appearance with shadowing created by the bony prominence at the brows)
  • facial volume loss at the midface
  • deeper nasolabial folds and marionette lines, and
  • worse jowling from excess skin, and skin excess in the neck with exposure of platysma bands and loss of neck contour.
VIew Facelift Results

Facial Rejuvenation For Ozempic Face Patients

Given these considerations, the facelift approaches for an “Ozempic Face” patient need to be altered from a more traditional approach. The Ozempic face will demand more:

  • skin removal
  • more aggressive tightening of the SMAS, and
  • higher volume of fat grafting

Why Facial Fillers Won't Do The Trick 

You're Getting Quantity Over Quality 

The “Ozempic Face” is characterized by a lean or overly gaunt appearance, which is almost cachectic in appearance. The leanness is exacerbated with excess skin which appears to almost fall off the face. It's often most notable along the jawline and neck.There's also volume loss, not merely from fat, due to loss of facial muscles as well. Where regular facelift patients need to address skin laxity and midface tissue descent, Ozempic Facelift patients present with:

It Can Lead To Distorted Facial Proportions

The face has a delicate balance of contours and proportions. By merely injecting large quantities of dermal fillers, there's a risk of not achieving harmonious results. Overfilling certain areas can lead to a puffy, artificial-looking appearance.

Ongoing Maintenance Costs Are A Major Turn Off For Most Patients

Dermal fillers aren't a permanent solution for the drastic volume loss that Ozempic patients battle. They require repeated sessions to maintain the desired appearance. Given the substantial volume loss post-Ozempic, the ongoing cost of maintaining this with injectable fillers can be excessive. Over time, patients might find themselves spending a significant amount without achieving the desired natural look.

The Superiority Of Facial Fat Grafting and Deep Plane Facelift

Long-lasting Results

Once the fat cells integrate into the facial tissues, they can provide lasting results. While some reabsorption might occur initially, the grafted fat generally has a high survival rate, offering sustained volume restoration.

Comprehensive Facial Rejuvenation

Combining facial fat grafting with a deep plane facelift addresses both volume loss and skin laxity. The deep plane facelift technique allows for the repositioning of deeper facial structures, including muscles, to provide a more youthful and refreshed appearance. This comprehensive approach ensures that patients achieve harmonious results without looking "done" or artificial.

Cost-effectiveness In The Long Run

While the upfront costs of procedures like facial fat grafting and deep plane facelift might be higher than injectable fillers, the long-term benefits and reduced maintenance requirements make them more cost-effective. Patients can achieve lasting results without the ongoing expenses associated with frequent filler treatments.

How Do We Get Enough Fat From Ozempic Patients?

The "skimming" liposuction technique stands distinctively tailored for thinner patients, presenting a refined approach to fat harvesting. Unlike traditional liposuction methods that take a lot of fat from limited areas, skimming focuses on extracting a small amount of fat from multiple areas to avoid contour irregularities and depressions. 

Tailored for Thin + Weight Loss Patients

Specifically designed for individuals with limited fat, ensuring a viable solution for facial or body contouring. Once harvested, the processed fat offers a versatile filler for various areas, allowing for comprehensive rejuvenation or subtle augmentation as desired. 

The Ozempic Facelift: Special Considerations

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Treating The Temples

Semaglutide patients have hollow and lax temples. Facelift incisions can be extended from the sideburn area to remove excess skin around the temples with an extended facelift incision. Then, I'll fan out micro-injections of fat to re-volumize the concave temple depressions that contribute to a bony and frail appearance. The final effect recreates a softer, more contoured temple area that is also more youthful.

Alleviating Sunken Eyes

Sunken eyes develop when the surrounding area of the eyes lacks volume, leading to a shadowy or fatigued look. There will be hollowing around the eyes which ages the patient and a deeper tear through deformity.

I'll do fat grafting to the upper and lower eyelids to soften the hollow appearance and recreate the ogee curve transition to the upper and mid-cheek. For patients who also now have excess skin at the upper and lower eyelids, I'll recommend an upper and lower eyelid lift in conjunction with their Lift and Fill Facelift.

In patients who have excess eyelid skin, I'll perform an eyelid lift or blepharoplasty, removing the excess skin in both the upper and lower eyelids. In cases where Ozempic patients have laxity in their lower eyelids, I'll retighten the eyelid using a technique called a canthopexy so to help pull the eyelid taught and eliminate a droopy appearance. 

Recontouring Midface Hollowing

Semaglutide patients often exhibit pronounced loss of volume in the midface, revealing underlying facial bones. To address this, I employ a focused approach, emphasizing aggressive fat grafting in the midface. Specifically, targeting areas like the malar eminence and Zygomatic arch, I meticulously reintroduce purified fat. This technique not only restores natural facial contours but also replenishes lost volume, ensuring a fuller, harmonious facial appearance for Semaglutide patients.

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Elevating The Lower Face

In extreme weight loss patients, the effects manifest prominently in the neck and lower face, where skin draping becomes evident. These patients, especially those on medications like Semaglutide, often exhibit excessive hollowing in the midface, emphasizing underlying facial bones. To address such profound changes, a standalone facelift may not suffice.

Excess skin and gravitational aging are the primary issues in the lower face. Tightening the SMAS layer and skin removal will restore the appearance and lessen the deep nasolabial folds, marionette lines, and jowls. Fat grafting can be used to further fill in the nasolabial folds and marionette lines. In females, a lip lift combined with fat grafting to the lips can further rejuvenate the perioral area.

The facelift procedure becomes a harmonious blend of lifting and volumizing. While the facelift elevates sagging tissues and repositions underlying structures, fat grafting acts as a vital adjunct. It replenishes lost volume, ensuring that as the skin is lifted, it drapes over a naturally contoured foundation.

This dual approach is paramount for extreme weight loss patients. By addressing both the sagging skin and the volume deficits, I can achieve a more holistic and natural-looking outcome.

Tightening & Re-Fitting Neck Skin

Skin removal and platysma band plication are the mainstays of treatment, and most massive weight loss patients have very little fat in the neck. Excess skin is removed with a neck lift, using extended incisions behind the ears and an incision under the chin is used to tighten the platysma muscle called Platysma plication. The platysma can be further tightened laterally using a platysma window to remove lateral platysma laxity. The incision behind the ears is generally extended down the posterior hairline for maximal skin removal. Lifting the skin and retightening the bands at the neck in conjunction with SMAS elevation will significantly alleviate the puddling skin along the jawline.

A Greater Degree of SMAS Tightening

The underlying layer of the face called the SMAS is generally more lax in the “Ozempic Face.” In most cases, tightening the SMAS is done using plication sutures to tighten the SMAS without removal of the tissue. However, in very lax cases, removing SMAS may be necessary with either a lateral SMASectomy or a deep plane resuspension technique. Regardless, the SMAS will require more tightening than the “average” facelift.

Even More Skin Tightening 

While a standard facelift does not require excess skin removal and primarily relies on SMAS tightening, the Ozempic facelift involves more thoughtful and strategic skin removal. The incisions are typically extended farther towards the temple and lower into the posterior hairline to allow for maximal skin removal. Failure to remove excess skin will result in under-correction of the Ozempic face.

Seek Experience and Expertise In Your Plastic Surgeon

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When you book your Ozempic Facelift, you're saying yes to rejuvenating your facial appearance. Please ensure you select a board-certified plastic surgeon for your procedure.

Dr. John Burns in Dallas, TX, employs both artistry and skill in using advanced techniques that go beyond mere surgery – we specialize in creating results that are as subtle as they are stunning. Click here to schedule your complimentary consult with Dr. Burns.

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