Fillers, Botox, facelifts, and neck lifts saw a notable increase in popularity in 2023, fuelled by a growing uptake of weight loss drugs, suggests a new report from the American Society of Plastic Surgeons (ASPS). To gain a New Zealand perspective, ProCollective tapped top cosmetic doctors in the country.

Increasingly, Ozempic, which belongs to a class of drugs called semaglutide, is being used off-label for weight loss. This has given rise to a new beauty concern, dubbed “Ozempic face.” Cosmetic dermatologist Dr Paul Jarrod Frank was the first to coin the term after noticing a trend of patients with gaunt faces following rapid weight loss on the drug.

While concerns about “Ozempic Face” have not been as noticeable in New Zealand, due to slower adoption of semaglutide drugs, experts anticipate that the trend may become more prevalent in the future.

Dr Paul Nola, a cosmetic doctor and NZSCM co-president, notes, “Overseas semaglutide is 10-100 times as popular, so the surge in people with this feature of large weight loss is more apparent. Our day will come. There are not that many in New Zealand yet with this problem.” Dr Sarah Hart echoed this, saying, “I haven’t noticed an increased demand for fillers to address facial fat loss caused by semaglutide. However, I have had a few patients seeking fillers following dramatic weight loss from gastric bypass surgery. It seems that semaglutide isn’t yet widely used in New Zealand, but it’s likely to become more common.”

It’s important to note that semaglutide drugs themselves do not directly cause loose skin. The accelerated weight loss associated with the drugs, which can surpass other weight loss methods like bariatric surgery, can make skin more susceptible to ageing and sagging. Age is also a major factor in the extent that gauntness is apparent. “Young people have the capacity to absorb that excess skin and tighten everything so they look great. Unfortunately, the older we get the harder it is to bounce back,” explains Dr Nola. “In menopausal or post-menopausal women as little as 2-3kg can affect it,” adds Clinic 42’s Dr Ellen Selkon.

How to restore volume in the face after weight loss

“Our current ability to tighten the connective tissue that holds up the face and body is still weak,” says Dr Nola. “So the options are either pull the skin back, snip off the excess and stitch back together (a $30-40,000 facelift) or fillers.”

Dr Hart recommends hyaluronic acid dermal fillers. “Cosmetic medicine doctors have been using fillers to address facial fat loss due to ageing for many years, making it a well-established treatment. Soft filler gel is gently placed in the fat layer, mimicking the appearance of fat to restore the curves of the cheeks. HA fillers are dissolvable, which is beneficial if they need to be reversed.”

Treatments that target collagen production can also help improve symptoms associated with rapid weight loss. “Healthier skin with more collagen and elastin can better resist sagging caused by fat loss. Therefore, collagen-boosting treatments like microneedling, fractional laser, and injectable skin boosters and polynucleotides can be helpful,” she adds.

Dr Selkon recommends Sculptra, which is Poly-L-lactic acid. “It’s also great for this type of treatment as it gradually but very naturally re-volumises the tissue, as well as lifts and tightens.”