What Happens To The Skin After Taking Semaglutide?

Semaglutides are a very popular class of weight loss medications that have resulted in a small revolution in the weight loss industry. Patients on these medications are losing weight in record amounts over relatively short time periods. While this has so many wonderful benefits, there are also issues with excess skin and early aging. While the skin does have some viscoelastic properties allowing it to conform to your body, these properties are not enough to prevent skin excess which is prevalent in the face, arms, breasts/chest, back, abdomen, flanks, butt, and thighs. Additionally, as we age the skin becomes even more susceptible to these changes. Patients losing significant amounts of weight will find themselves dealing the excess skin.

Treatments For Ozempic Face

Ozempic face often exhibits pronounced signs of aging. The brow and eyelids appear heavily burdened by excess skin.  The mid-face, particularly the cheek area, experiences sagging due to a loss of volume and muscle. As a result, the junction between the lower eyelid and cheek becomes more noticeable, leading to the development of tear-trough volume loss. Additionally, nasolabial folds and marionette lines become more prominent, as do the jowls due to surplus skin. The once-defined jawline loses its well-defined contour while the neck contour also becomes less angular and tight.

The Ozempic Facelift

The following changes need to be considered for an Ozempic Facelift. This procedure involves addressing the loss of facial volume and excess skin. To deal with excess skin, it is best to use a deep-plane approach. Most of the work involves lifting the Submuscular Aponeurotic System (SMAS) internally to address excess skin. Once the SMAS is lifted, the excess skin can be repositioned, and any extra skin can be removed with minimal tension. Additionally, lost volume needs to be replenished with an autologous fat transfer. Fat is taken from the body, purified, and divided into micro and nano-fat components. Subsequently, the fat is injected into areas of the face where fat has been lost, such as the temples, lower eyelid/cheek junction, cheeks/midface, nasolabial folds, marionette lines, lips, and jaw. This approach is particularly effective for weight loss patients and is called a "Lift and Fill" facelift.

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The Ozempic Facelift
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Fat Transfer for Ozempic Face

To restore lost fat and volume, autologous fat is the best option. There is an "unlimited supply" of fat, making it much more practical than commercially available fillers for full correction. You will notice that it takes much more volume for filling than with a typical filler patient. Fat is mostly harvested from the abdomen, flanks, and thighs since these areas have a higher concentration of stem cells. The harvested fat is first washed with sterile saline to remove all impurities. The fat is then centrifuged for 1 minute to highly concentrate it. Once centrifuged, the fat is passed through filters to give it a finer consistency for delicate areas. The first filter yields a micro-fat component, and the second filter gives nano-fat, which is the most delicate. Fat that is injected deeply needs to be thicker, so this fat is not filtered. Unfiltered fat is typically used to provide a lot of volume over body areas such as temples, midface/cheek, and jaw. Micro-fat is used for mid-level injections, such as nasolabial folds or marionette lines, and fine or nano-fat is used in the lower eyelids and lips. 

Research More: Facial Fat Grafting With Micro and Nano Fat

Addressing Skin Texture After Ozempic Face

People with heavier faces often experience more skin texture irregularities due to the stretching of the skin from weight gain. This can lead to a red or ruddy complexion, larger pores, fine lines, and wrinkles. Laser resurfacing, either fully ablative or fractionally ablative, is considered the most effective method for improving skin texture and boosting collagen production.

Laser Resurfacing

CO2 lasers offer better tightening but can have unwanted side effects such as loss of pigmentation, extended healing time, and a waxy appearance of the skin. Fractionally ablative CO2 lasers provide slightly less tightening but have fewer side effects and quicker healing.

Erbium Lasers

Erbium lasers are more precise and can be adjusted to deliver both fully and fractionally ablative intensities. They target water in the skin and have fewer side effects while producing a more natural-looking result.

Other Skin Refining Methods

Other skin resurfacing options include deep chemical peels like phenol and higher concentration TCA chemical peels (Trichloroacetic Acid peels). Fractionally ablative lasers such as Sciton Halo are often performed as a series of treatments. Microneedling with PRP (platelet-rich plasma) administered as a series is also a useful resurfacing option.

Nonsurgical Treatments For Ozempic Face

Nonsurgical treatments are focused on skin tightening and replacing lost volume. They are generally more effective for younger patients who have lost less weight. For skin tightening, ultrasound or radiofrequency treatments are commonly used. Ultrasound tightens tissue below the skin by generating heat and can be delivered using devices such as Ulthera or SofWave. On the other hand, radiofrequency treatments can be applied externally using micro-needling with Morpheus 8 or below the skin with FaceTite. Both methods generate heat to tighten tissue and produce a firming effect over time.

FDA-approved Dermal Fillers For Facial Recontouring

Dermal fillers serve as an effective solution for restoring lost facial volume. Typically, denser hyaluronic acid formulations, such as Juvederm Voluma, Volux, Vollure, or Restylane Lyft, are favored for achieving the best results. These hyaluronic acid fillers are hydrophilic, allowing them to attract and retain water, thereby significantly improving volume and fullness in the treated areas.

The Liquid Facelift: A 40 Year-old Woman's Facelift in A Syringe

Neuromodulators For Skin Smoothing

Botox and other neuromodulators like Dysport, Daxxify, Juveau, or Xeomin can be injected to smooth the skin by relaxing the overactive muscles of facial expression. They are most effective in the upper third of the face, targeting the forehead, glabella, and crow’s feet. Additionally, neuromodulators can help lift the brow or corners of the mouth, creating a more relaxed, refreshed, and youthful appearance.

Botox or Brow Lift- How To Tell What You Need

Collagen-stimulating Filler Injections

Another popular option for facial fillers is a class of fillers that stimulate collagen production, called biostimulators. Sculptra and Radiesse are commonly used as collagen stimulators to add volume to the face and replace lost collagen. Sculptra in particular is very effective, but it requires a series of treatments and maintenance. Collagen is produced with each treatment, resulting in significant rejuvenation over time. Radiesse is a temporary filler that provides more immediate filling before collagen production takes over. Sculptra uses Poly-L-lactic acid, while Radiesse uses calcium hydroxyapatite. Both fillers are very useful for addressing facial volume loss.

Learn More: Sculptra Filler For Facial Rejuvenation- A Comprehensive Guide

 Post-Ozempic Body Contouring

Breast Lift

After weight loss or pregnancy, breasts may become saggy and lose their shape. This happens because the skin stretches as the breasts expand, and after the weight is lost or after pregnancy, the breasts might lose volume and appear droopy. A breast lift procedure involves repositioning the nipple/areola to the breast crease level or at the mid-level of the upper arm. Excess skin is removed from the lower part of the breast, and the breast tissue is moved upward to its natural position on the chest. The skin is then wrapped around the breast to provide support. In some cases, an internal mesh bra like Galaflex or Durasorb may be used to offer additional lift and support for longer-lasting results. 



View Breast Lift Results Here
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Male Chest Reduction

The chest area is also a problem for many men who have lost weight. Like a condition called gynecomastia, larger breast tissue and excess skin can affect men. The excess fat is removed with VASER® ultrasound liposuction which is more aggressive and effective for removing both breast tissue and resistant chest fat in men. Excess skin is removed with a modified male breast lift or using the areola to hide the scar from skin removal which we call a periareolar (around the areolae) breast lift.

Review Male Chest Reduction
Read The Blog: Lipo For Men: How It's Different

Breast Augmentation with Breast Lift

In females, it’s often essential to combine a breast lift with volume augmentation to achieve a balanced breast aesthetic while replenishing depleted breast tissue. Implants create a fuller, rounder bust line and restore the breast's shape, enhancing upper pole fullness and maximizing cleavage. Additionally, an internal mesh bra is frequently utilized to support both the implant and the lifted breast, ensuring better longevity for the breast implants, especially in massive weight loss cases.

If a woman prefers to enhance breast fullness without implants, fat grafting can be an effective alternative, providing natural shape and volume enhancements. However, it’s important to note that weight loss patients typically have less fat available for harvesting; this aspect should be thoroughly discussed during your consultation with Dr. Burns to tailor the approach to your specific needs.

Learn More: Do I Need A Breast Lift or Breast Reduction?

Tummy Tuck

The abdomen is often a problem area for those using Ozempic. Weight gain can lead to excess skin and fat in the lower abdomen, extending to the sides and lower back in extreme cases. A tummy tuck, or abdominoplasty, aims to remove the excess skin and fat, while also tightening the abdominal muscles to flatten and recontour the abdomen. Liposuction is used for additional body contouring at the upper abdomen and waist. The tummy tuck incision is typically made below the bikini line, extending horizontally (extended tummy tuck) to ensure the complete removal of all excess skin. After removing the skin, the separated abdominal muscles are tightened from the rib cage to the pubic area. Additional tightening can be done on the sides to bring in the waist further, using a technique called a corset or 3-vector plication. Finally, VASER® high-definition ultrasound liposuction is used to remove excess fat from the upper abdomen, flanks, and lower back to achieve a tightly contoured 360 shape.

360-Degree Body Lift

In some cases, significant weight loss can result in excess skin around the torso, making a circumferential abdominoplasty or belt lipectomy the best option. This procedure not only removes excess skin but also lifts and tightens the tissue of the thighs and buttocks. By removing the excess skin, the problematic skin of the front, sides, and back of the thighs is lifted.

A buttock lift is also performed during a body lift. With weight loss, the buttocks can often sag and appear flat. Lifting the buttocks gives a much better shape and smooths the skin. In many cases, butt volume can be restored to provide better shape and volume.

This volume is added using a fat transfer, where fat is removed from the abdomen, flanks, and thighs, and then repurposed and added back to the buttocks. The fat transfer is very popular for weight loss patients and is known as a Brazilian Butt Lift or BBL.

Thigh Lift

The skin at the inner thighs is particularly prone to sagging following weight loss. This area tends to have thinner and looser skin, which can lead to a drooping appearance. To address this, surgeons typically perform a thigh lift using an incision that runs from the groin along the inside of the thigh. The length of the incision corresponds to the amount of loose skin to be excised, usually extending up to the distal third of the thigh, but often stopping before the knee.

In cases with less excess skin, a shorter horizontal incision can be made in the groin area, allowing for discreet concealment under panties. A medial thigh lift is commonly incorporated into a lower body lift and frequently combined with Vaser liposuction. This approach allows for the removal of excess fat before skin excision, resulting in a more sculpted and streamlined thigh.

Learn More: Ozempic Thighs: Solutions For Saggy Skin and Saddlebags 
Research: What To Do About Ozempic Butt

What You Need To Know To Prepare For Surgery

Weight loss surgery is a highly involved procedure that requires careful planning. It can lead to life-changing results, but it's crucial to plan for a proper recovery.

To be an eligible candidate, patients should be in good health with a BMI below 35, and ideally below 30 for optimal outcomes. Patients need to discontinue the use of weight loss medications before surgery, as they can interfere with anesthesia. Patients should also refrain from smoking or taking blood thinners like aspirin. Those with sleep apnea should obtain medical clearance from their primary care physicians and consider staying overnight for observation following surgery.

For the sake of optimal healing and safety, weight loss surgery should be thoughtfully planned. It's recommended to keep the surgical time under 6 hours with minimal anticipated blood loss. This often means scheduling multiple procedures in stages. Patients should prioritize the most important procedures and schedule those first before moving on to less critical ones.

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Recovering From Plastic Surgery After Ozempic

Recovery is a crucial phase that requires careful planning. For most body contouring procedures, the first week is typically the most challenging. Dr. Burns administers Exparel during surgery to numb the surgical areas, which helps to minimize pain. Despite this, some discomfort is expected, and pain medication will usually be necessary.

It's essential to walk frequently after surgery, even though it may feel difficult. This practice is vital for reducing recovery time and preventing blood clots, known as deep venous thrombosis (DVT). Dr. Burns has established a protocol to help prevent DVTs, which all patients will be required to follow. Most patients will spend the night at our specialized facility, The Cloister Recovery Center, where our nursing staff will provide monitoring and support.

You can expect to return home the following day. During the first week, you’ll likely need assistance with daily activities such as showering, cleaning, and cooking. This initial week is particularly intense, and while you may feel somewhat restricted to your home, you won't be bedridden since walking is essential. You will be issued compression garments, drains, and dressings for your incisions. Additionally, you will receive comprehensive instructions on how to care for yourself following surgery.

The following week becomes significantly easier as you'll find it simpler to walk and manage daily self-care. You may even be ready to drive and run some errands. At this stage, expect to operate at about 50% of your usual capacity. It's crucial to prioritize rest, stay hydrated, maintain a healthy high-protein diet, and meticulously care for your incision as directed.

After the initial weeks, you'll start to appreciate your results and can gradually ease back into light exercise. Dr. Burns will conduct regular check-ins to adjust your activity level as your healing progresses. Remember, it takes a full six months to fully see your final results, as your incision will need time to mature and the swelling to subside. Once healed, we will take after photographs to compare with your before images and formally assess your results.

Book With Body Contouring Expert, America’s Best Plastic Surgeon,
Dr. John Burns MD

Ready to take control of your post-weight loss transformation? Schedule a consultation with Dr. John Burns, MD, one of America’s top body contouring experts. With extensive experience in addressing the unique challenges that come with rapid weight loss, Dr. Burns can help you reclaim a youthful, toned appearance. Whether it's an Ozempic facelift, body lift, or other advanced procedures, Dr. Burns will customize a plan that aligns with your goals.

Don't let excess skin hold you back—book your consultation today and discover how to achieve the confident, defined body you deserve. 

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Schedule Your Ozempic Body Contouring Consultation with
Dr. John Burns, MD, FACS

Schedule your private consultation with Dr. John Burns. Dr. Burns offers both virtual and in-office plastic surgery consultations women and men who are ready to recontour their physique after Ozempic, Mounjaro, and Wegovy weight loss medications