Ozempic face: what causes it and what are the solutions?

Key points to remember.

“Ozempic face” refers to a loss of facial volume associated with rapid weight loss.
The areas most affected are the cheeks, the temples and the eye contour, which appear more hollow and lax.
This phenomenon is explained by a reduction in adipose tissue and sometimes muscle tissue, associated with an alteration in skin quality (collagen, elastin, lipids).
Prevention of “Ozempic face” relies primarily on regular medical monitoring, gradual weight loss, and an appropriate diet.
Aesthetic treatments (injections, radiofrequency, PRP, etc.) can help improve the “Ozempic face”, but they must be performed by professionals.
Cosmetic products, for their part, cannot restore lost volume, but can support the overall quality of the skin.

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Focus on the Ozempic treatment.

Ozempic is the brand name of a medicine whose active substance is semaglutide, a molecule initially developed for the treatment of type 2 diabetes.

It belongs to the class of GLP‑1 (glucagon‑like peptide‑1) receptor agonists, a hormone that is naturally produced by the body and involved in the regulation of blood glucose levels. Since its approval, semaglutide has been used to help control blood sugar levels in patients with diabetes, in the form of weekly injections or tablets. However, its effects on body weight have contributed to its popularity beyond the field of diabetes, against the advice of health authorities.

The mechanism of action of semaglutide is based on several complementary processes. By binding to GLP-1 receptors located in particular in the pancreas, the digestive system and the brain, it stimulates insulin secretion when blood glucose levels are high and reduces the release of glucagon, thereby helping to lower blood sugar. This mechanism allows blood glucose to be regulated in a more physiological manner, with a limited risk of hypoglycaemia. At the same time, semaglutide also acts on the central nervous system, particularly on the hypothalamus, a region involved in the regulation of appetite. This specific action explains its effects on body weight. Semaglutide helps to reduce the sensation of hunger and to prolong the feeling of fullness, leading to a reduction in caloric intake, which can result in sometimes rapid weight loss.

15 to 25%

Of average weight loss after one year of treatment with semaglutide.

300%

Of increase in prescriptions of GLP-1 receptor agonists between the beginning of 2020 and the end of 2022.

While Ozempic can be beneficial for people with diabetes when used in a properly supervised medical setting, its off-label use for weight loss in individuals without diabetes poses serious public health concerns (supply pressures affecting diabetic patients who genuinely need it, health risks for non-diabetic individuals who take it, and so on).

Note : Ozempic is not the only medicine that contains semaglutide. This active substance is also found in Rybelsus and Wegovy.

"Ozempic face": how can this side effect be explained?

The term “Ozempic face” refers to a set of changes in the face observed in some individuals after rapid weight loss, often associated with the use of semaglutide. In practical terms, the face appears more hollow, less full, giving an impression of drawn or tired features. The areas most affected are the cheeks, temples, eye contour and neck, where one observes a loss of volume, skin sagging and an accentuation of wrinkles, particularly the nasolabial folds and marionette lines. This phenomenon is not specific to Ozempic itself, but it has been widely publicised under this name due to the drug’s popularity.

Avant (gauche)/après (droite) la prise d'Ozempic, avec des manifestations de l'"Ozempic face". — Before (left)/after (right) taking Ozempic, showing manifestations of “Ozempic face”.
Source: GOLDBERG D. J. & al. Semaglutide “Ozempic” face and Implications in cosmetic dermatology. Dermatological Reviews (2024).

From a biological perspective, this transformation is primarily explained by a reduction in subcutaneous adipose tissue, which plays a major role in supporting and structuring the face. A youthful face is generally associated with a harmonious distribution of volumes, particularly in the cheekbone area. When significant weight loss occurs, this lipid reserve decreases, making the bony contours more visible and giving the face a “sunken” appearance. In addition, there may be a partial loss of muscle mass if daily protein requirements are not met, which also contributes to altering the support of the facial tissues.

Moreover, the very quality of the skin itself can be affected. Rapid weight loss is sometimes accompanied by a reduction in nutritional intake or an imbalance in micronutrients, which can interfere with the synthesis of collagen and elastin, two proteins that are essential for skin firmness and elasticity. At the same time, the skin barrier may be weakened, particularly due to a reduction in epidermal lipids (ceramides, fatty acids, cholesterol), promoting dryness and a duller complexion.

All of these mechanisms together give the face an appearance suggestive of accelerated skin ageing, although in reality this phenomenon is related to a loss of volume.

How can “Ozempic face” be prevented?

Preventing “Ozempic face” is based on a comprehensive approach that combines medical supervision, lifestyle measures and appropriate care. It is first and foremost essential to recall that semaglutide is a medicine intended for the treatment of type 2 diabetes, and that its use must be on prescription and under medical supervision. Rapid weight loss, especially when pursued for purely aesthetic reasons, can lead to adverse effects, including consequences for the face. Medical oversight makes it possible in particular to adjust the rate of weight loss and reduce these effects.

Upstream or at the start of treatment, certain aesthetic medicine techniques can help preserve skin quality. Methods aimed at stimulating collagen production and maintaining skin elasticity, such as radiofrequency, photobiomodulation or certain biorevitalisation approaches, can help the skin adapt more effectively to volume changes. Do not hesitate to seek advice from your dermatologist before starting a semaglutide-based treatment, so that they can guide you towards the technique best suited to your skin and your particular situation.

The objective is not to compensate for fat loss, but rather to support the cutaneous tissues in order to limit sagging and loss of firmness.

In parallel, diet can help. An adequate protein intake is essential to maintain muscle mass, including the muscles that help support the face. As a guideline, recommendations are generally around 0.8 to 1 g of protein per kilogram of body weight per day, or even more (up to 1.2–1.5 g/kg/day) during periods of weight loss or in physically active individuals, in order to limit muscle wasting. Beyond protein, it is important to avoid overly strict dietary restriction, which could accelerate weight loss and increase tissue loss. The aim remains to prioritise a balanced diet, including in particular unsaturated fats (avocado, oily fish, nuts, seeds, etc.), which are beneficial for proper cellular function, as well as of course fruit, vegetables, pulses, whole grains, etc.

Can “Ozempic face” be treated?

When changes to the face are already established, several options can be considered to lessen their appearance. The first, in theory, is to stop semaglutide, which may halt further volume loss, but this is not necessarily possible for people with diabetes. Fortunately, there are other, more targeted approaches with varying degrees of intervention, ranging from minimally invasive dermatological techniques to surgical solutions. Current aesthetic procedures are mainly based on two approaches: restoring volume, for example with hyaluronic acid injections or fat grafting, and stimulating the activity of the extracellular matrix to improve skin firmness and elasticity, using microneedling, radiofrequency treatments, or PRP (platelet-rich plasma). Below is an overview of the main options currently in use, together with their advantages and limitations:

Technique	Advantages	Limitations
Discontinuation of semaglutide	Stops volume loss. No additional cost.	Not necessarily possible for individuals with diabetes. Does not completely correct the aesthetic changes.
Surgery (lifting, lipofilling)	Significant, long-lasting results. Possibility of treating multiple areas.	Invasive procedures, prolonged recovery, high costs.
Injections (dermal fillers)	Rapid results, minimally invasive. Adaptable to hollowed areas.	Temporary results. Technique involving risks (bruising, migration, reactions) and high cost.
Microneedling	Improves the skin’s texture and firmness.	Several costly sessions are required. Does not always satisfactorily correct volume loss, as it targets only the dermis.
PRP (platelet-rich plasma)	Uses the patient’s own cells. Stimulates skin regeneration.	Blood sample required. Progressive results.
Energy-based devices (radiofrequency, ultrasound)	Non-invasive. Improves skin firmness and texture.	Gradual results. Several sessions are often required.

The advantages and disadvantages of potential treatments for the “Ozempic face”.

Source: GOLDBERG D. J. & al. Semaglutide “Ozempic” face and implications in cosmetic dermatology. Dermatological Reviews (2024).

It is important to emphasise that these approaches fall within the medical and aesthetic fields and require a personalised assessment by a suitably qualified professional.

Are cosmetic treatments effective against “Ozempic face”?

With the increasing use of Ozempic as a treatment, some cosmetics brands have rapidly identified a new concern – and a marketing opportunity. We are now seeing the emergence of products promoted as being able to target the so-called “Ozempic face”.

However, it is important to be clear: cosmetic products cannot correct a loss of facial volume.

In fact, “Ozempic face” is linked to a reduction in adipose tissue and, to a lesser extent, muscle mass, two structures located in the deeper layers of the skin, in particular the hypodermis. However, cosmetic products, by definition, act mainly at the level of the epidermis and the superficial layers of the dermis. They do not penetrate deeply enough to stimulate the production of adipocytes or to restore the lost volume. Thus, even the most sophisticated formulations cannot compensate for this kind of structural change.

Note : This does not mean, however, that cosmetics are useless in this context. Well-formulated products can help improve the overall appearance of the skin by supporting hydration, barrier function and complexion radiance. These effects are nevertheless complementary and should not be mistaken for an effect on facial volume.