Here’s How to Restore Facial Volume After GLP-1 Weight Loss

GLP-1 weight loss medications like semaglutide (Ozempic®, Wegovy®) and tirzepatide (Mounjaro®) have rapidly grown in popularity for their ability to support significant and sustained weight loss. For many patients, these medications offer life-changing health benefits. Clinical trials have shown semaglutide use can lead to weight reductions of 14.9% to 17.4% in individuals without diabetes (Wilding et al., 2023).

While the benefits of rapid weight loss are immense, some individuals notice unexpected changes to their appearance, particularly in the face. As body fat decreases, facial fat is often lost as well, and lost dramatically. This can result in a thinner, more aged facial appearance, even in younger patients. Fortunately, we have highly effective, non-surgical dermal filler and biostimulatory treatments available to restore facial volume, and noninvasive tissue tightening devices to help saggy skin and rejuvenate your look.

In this post, I’ll explain why facial volume loss occurs with GLP-1 medications, ways to minimize unwanted facial fat loss, and how simple cosmetic treatments can safely and effectively restore lost volume and improve lax skin.

Understanding Facial Volume Loss

Facial volume loss refers to the gradual reduction of the fat pads, connective tissues, and supportive structures that give the face its natural fullness and contour. These internal components create the smooth, youthful curves we associate with a vibrant, healthy appearance. When volume is lost, whether due to natural aging, weight loss, or both, the face may appear thinner, more angular, and less firm.

While this change in appearance following weight loss is often called “Ozempic Face”, this type of change is not unique to GLP-1 medications. Indeed, facial fat loss occurs with any significant weight loss, whether through diet, exercise, bariatric surgery (gastric bypass), or illness. The body does not target fat loss selectively, and unfortunately, the face is often one of the first areas to show the effects.

In addition to weight-related changes, normal aging contributes to facial volume loss, even in individuals who maintain a stable weight. As we age, the body naturally produces less collagen and elastin, and the deep fat compartments in the cheeks, temples, and around the eyes begin to shrink and shift downward. Bone resorption (the gradual thinning of facial bones) further contributes to a hollowed appearance over time.

The result of these changes can include:

• Flatter or sunken cheeks
• Prominent or dark under-eye area or “tear troughs”
• Deepened folds or creases, especially around the mouth
• A more pronounced jawline with less midface support
• Thinning skin that loses its bounce and elasticity
• A general “drawn” or tired appearance

While some patients embrace these changes as a natural part of aging or weight loss, others feel that their facial appearance no longer reflects how energetic or healthy they feel on the inside. Fortunately, these changes can be addressed if desired, often with subtle, non-surgical treatments that restore volume and soften facial contours without dramatically altering your appearance.

How Weight Loss Through GLP-1 Medications Causes Facial Volume Loss

GLP-1’s support weight loss by regulating appetite, slowing gastric emptying, and improving insulin sensitivity. The result is a reduction in total body fat, including in the face. It is important for patients to understand that weight loss medication will affect fat stores evenly, and unfortunately, the facial fat pads that provide fullness and youthful contours are often among the first to shrink.

While the change is not dangerous, it can be distressing for those who feel like their outer appearance no longer reflects their inner vitality.

Can Facial Volume Loss Be Prevented on GLP-1s?

Some degree facial fat loss is likely to occur with any form of significant weight loss. Unfortunately, there is no way to fully prevent such volume loss from occur. There are, however, steps you can take to slow the process and support your skin throughout your journey:

• Lose weight gradually when possible. Talk to your provider about your desire to lose the weight slowly. Steady weight loss tends to reduce the severity of facial hollowing.
• Stay hydrated. Proper hydration helps maintain skin elasticity and volume. The best way to keep water in the skin is to increase your intake of healthy fats to strengthen your skin barrier.
• Support collagen production. Eat a balanced, protein-rich diet and consider collagen peptides if approved by your healthcare provider.
• Use targeted skincare. Retinoids, peptides, and hyaluronic acid serums help improve skin firmness and resilience.
• Avoid smoking and limit sun exposure. Both accelerate collagen breakdown and increase visible aging.
• Consider preventative treatments. Undergoing non-surgical treatments like fillers, microneedling with PRP, and Ultherapy can help maintain skin structure during active weight loss.

Treating Facial Volume Loss With Fillers

For patients who want to restore lost volume and droopy skin,  and rejuvenate their appearance, dermal fillers offer a safe, effective, and non-surgical solution. There are two main categories commonly used for facial volume restoration:

Hyaluronic Acid (HA) Fillers

Smooth gel-based fillers like Juvederm, Restylane, and Belotero work by attracting and retaining water in the skin, instantly adding volume and smoothing contours. HA fillers are ideal for addressing:

• Cheeks
• Under-eye hollows
• Nasolabial folds
• Marionette lines

Results are visible immediately and typically last between 6 to 18 months, depending on the product used and the area treated. Filler results can also be extended permanently by undergoing periodic “maintenance” treatments.

Poly-L-lactic Acid Filler (Sculptra)

Rather than filling the face directly, Sculptra stimulates your body’s own collagen production over time. It is an excellent option for more generalized facial volume loss, including:

• Hollow cheeks
• Sagging lower face skin
• Temples
• Overall facial thinning

Results develop gradually over a series of treatments (usually 3 sessions spaced 4–6 weeks apart), with full results appearing in a few months. Effects can last up to 2 years or more, and many patients benefit from annual maintenance treatments.

An added benefit to this biostimulatory filler type is that it strengthens the skin’s internal structure by boosting the skin’s production of firming proteins like elastin and collagen. In this manner, Sculptra also provides long-term improvements in skin texture and firmness.

Choosing the Right Filler for You

The best filler (or combination of fillers) depends on your unique anatomy, goals, and degree of volume loss. In many cases, a blend of hyaluronic acid fillers and Sculptra provides the most natural and balanced result. An experienced injector will be able to ensure a safe, customized treatment plan to address each patient’s individual needs and goals.

We can boost the effects of the fillers by combining these treatments with tissue tightening devices like Ultherapy. When used together we see the best, most natural outcomes. And the good news is that you don’t need to wait until you have finished your weight loss journey. Early intervention is key to obtaining the best results.

Final Thoughts

GLP-1 medications are powerful tools for weight loss and metabolic health, but they can sometimes lead to unintended facial changes. Facial volume loss is a normal, and treatable, part of the process.

Fillers and biostimulators are an excellent non-surgical option that restore fullness, smooth contours, and bring back a more rested, youthful appearance. When coupled with non-invasive tissue tightening devices like Ulthera, we can impact meaningful change.  Whether you are looking to prevent volume loss or reverse it, personalized care from an experienced provider can help you feel more confident in your skin.

Sources:

Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Sanchez M, Seoane L, Wadden TA. Semaglutide for the treatment of overweight and obesity: A review. Obesity Reviews. 2023;24(2):e13715. doi:10.1111/obr.13715 https://pmc.ncbi.nlm.nih.gov/articles/PMC10092086/

Elizabeth Geddes-Bruce, MD is a board certified dermatologist and dermatologic surgeon specializing in the practice of both cosmetic and medical dermatology. Dr. Geddes-Bruce is fellowship-trained in cosmetic dermatology and laser surgery. She served as Chief Resident at one of the nation’s top dermatology programs – The University of Texas at Houston and M.D. Anderson Cancer Center.

Disclaimer: The contents of the Westlake Dermatology website, including text, graphics, and images, are for informational purposes only and are not intended to substitute for direct medical advice from your physician or other qualified professional.