Not so long ago, a pc28 artist whispered a theory on set. They claimed that when a client sat in their chair, they could instantly tell if they had been taking Ozempic, the newly available in Canada Wegovy or some other semaglutide medication, by looking at their skin.
It was, they said, a change in the quality of the skin itself, beyond “Ozempic face,” the term often used to describe the hollowed cheeks and newly-prominent lines that can accompany rapid .
It isn’t the first whisper about this from those who work up close with image-conscious public figures. “Colleagues on film shoots are gabbing about resorting to old-school techniques to deal with the thinner and looser skin that can come post-Ozempic but pre-surgical intervention,” read a March The Ankler article titled that quoted makeup artist Jesika Miller. She said that while Joan Crawford used to wear a clip at the back of her neck to cinch loose skin, now strategies include using face tape to lift sagging skin, or in a pinch, tying the hair back very, very tightly.
In a brave new world where research on the effects of these drugs is constantly emerging — everything from their potential to slow Parkinson’s to a possible link to possible — the Ozempic skin theory warranted an closer look.
So: Does taking a semaglutide medication do something to your skin’s texture? “It’s a very good question, and I don’t know if I have all the answers,” said Montreal cosmetic dermatologist Dr. Roni Munk. “It’s a novel drug, and we’re learning more and more all the time.”
Munk does confirm that he’s seeing patients on a daily basis who have lost a significant amount of weight in a short amount of time, and are unhappy with the way the skin on their face looks.
Many of those folks are on Ozempic, he said, but some have undergone gastric bypass surgery, or chemotherapy, all of which cause rapid weight loss and tend to result in the same patient concerns.
“These people are coming into my office and telling me they look tired, they’ve aged 10 years in the last six months, their complexion looks more dull, the colour has been lost, the sagging is excessive,” said Munk.
He uses an analogy to explain why this might be happening: Think of the structure of your face as a table — the bones, the volume from fat and muscle — and your skin as the tablecloth draped over it. “It fits beautifully when we’re young and the volume is full and the bones are structured,” Munk said. “But as we age or if there is rapid weight loss, the underlying structure of the table is shrinking, and the tablecloth no longer fits.”
Cue jowling and sunken eyes, because the skin is now too lax — too big, basically — for the shrunken underlying support. This is exacerbated by the fact that much of that structure you’re losing is made up of the deep and superficial fat pads in your face.
“The fat of your face is what really gives you that youthful look,” Munk said. “When that fat is lost, the cheeks and the jawline are going to go in the direction of gravity.” For these patients, he suggests treatments designed to restore volume in the face, such as fillers or biostimulators that encourage your body to regenerate its own tissue.
We also know that there’s a connection between nutrition and skin, something Munk pointed to as another possible reason Ozempic skin might have a certain “look” to it.
“These people have a decreased appetite, so they could easily be malnourished and not getting the essential vitamins and nutrients in,” he said. “That will definitely impact the quality of your skin, the glow in the skin and create a dull skin tone.”
In more speculative territory, Munk said he “wouldn’t be surprised” to learn down the line that GLP-1 peptides may impact collagen production, “because a lot of these enzymes are interconnected.”
While it’s more of a concern on the body than the face, muscle mass loss has been linked with taking these medications, and that could affect the skin’s appearance, noted pc28dermatologist Dr. Lisa Kellett.
“You have these people who are taking Ozempic for weight loss, but they end up with a new problem, which is a decrease in muscle mass,” said Kellett, who said this tends to be a particular issue for women, who already experience muscle mass loss as they age. “This muscle mass loss can be quite significant.”
It’s why we’ve seen the rise of post-Ozempic cosmetic “body contouring” treatments, which aim to tighten the lax skin that results from rapid weight loss as well as rebuild some muscle. In her office, Kellett uses Emsculpt Neo, a non-invasive device that claims to be able to add 25 per cent muscle thickness to a treated area with four 30-minute treatment sessions.
Those looking for more significant interventions might find themselves in Dr. Ron Somogyi’s pc28clinic. His plastic surgery practice focuses on clients who have lost large amounts of weight, typically in excess of 50 pounds.
On the day of our interview, he’d seen around 12 patients, and half of them had been taking Ozempic. He said he can tell by looking at someone’s face whether they’ve lost a large amount of weight, whether it’s after taking the medication or having bariatric surgery.
The commonality between those two interventions is that they’re associated with very rapid weight loss, which all three doctors posit could be an exacerbating factor here, leading to a “more severe version” of what happens with any weight loss, as Somogyi puts it. For example, if you’re losing weight fairly slowly without medical intervention, it might take 50 pounds of weight loss for you to see the kind of facial changes that someone on Ozempic will notice after only 20 pounds because that change occurred so quickly.
“Your skin doesn’t really have time to recover,” said Somogyi. “If you lose weight slowly, your body compensates by saying, ‘Things are starting to droop; I’m going to build more collagen to support and lift things.’” Collagen takes six to eight weeks to rebuild, so slower weight loss gives your skin more time to catch up.
Somogyi notes that these “esthetic side effects” tend not to be studied by drug manufacturers, because their focus is on safety and efficacy. They are, however, a very real concern for the people who come to see him. “Patients tell me that they feel so much better, but they don’t look better. They say they look much more sad or tired than they feel,” he said.
Somogyi points out that if someone was taking Ozempic to treat diabetes — its approved use — and lost weight as a side-effect, changes in the skin may be caused by the condition itself. “Diabetes affects the circulation in the little blood vessels in the skin, which impacts the tone and texture,” he explains. “There’s no question that when we operate on patients that have poor sugar control, we physically see differences. It feels different — it doesn’t stretch the way we want it to stretch, and it doesn’t heal with as nice scars.”
When patients choose plastic surgery, they might opt for a “weight loss face lift,” which is different from a face lift you might get later in life. In a few weeks, Somogyi will perform one on a woman who’s in her twenties and has lost over 150 pounds after a combination of gastric bypass and Ozempic. He’s already operated to address loose skin elsewhere on her body. “It’s not so much the face, because the bone is like the hanger, but the neck has no support,” said Somogyi. “For people that lose weight very quickly, it’s the lower face and neck that bothers them.”
But he often advises people who have lost a lot of weight to give their bodies a little longer to readjust before they consider surgical intervention. “You need to be patient. Let the collagen build, let your hormones normalize,” he said. In the meantime, he’ll recommend non-invasive treatments like micro-needling or radiofrequency that can help thicken the skin and stimulate collagen. “It could be that if you lost the weight in six months, you’re probably going to need a year before your body catches up.”
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