Glucagon-like peptide-1 receptor agonists, often known as GLP-1s, have transformed the management of obesity and metabolic disease. First developed for diabetes, drugs such as semaglutide and tirzepatide regulate blood sugar, suppress appetite and induce satiety. For the first time, large numbers of patients are achieving sustained, clinically-significant weight loss, often 15 to 20 per cent of body weight in under a year.
The medical benefits are clear. Cardiovascular risk falls, type 2 diabetes becomes easier to manage, and energy levels rise. Patients report that they move more freely, sleep better, and feel healthier than they have in years. Yet medicine rarely gives benefit without trade-offs. The rapidness of weight loss on GLP-1 therapy can have visible costs. Cheeks hollow, temples sink, jawlines lose definition, and skin slackens. Arms and abdomens may sag; thighs reveal redundant folds.
Social media has labelled this “Ozempic face”, a phrase that trivialises what is, in fact, a complex set of structural and psychological changes. At Self London, on Harley Street, we see many patients thrilled with their weight reduction yet unsettled by their reflection in the mirror. They feel younger and lighter but sometimes appear older or tired. This guide explains why these changes occur, what they mean for face and body, and why a device-first strategy offers the safest, most intelligent way to restore balance.
Why rapid weight loss alters the face
The youthful face is maintained by bone structure, ligament tension, discrete fat pads, and healthy skin. Over decades, natural ageing gradually reduces these structures’ support: bone remodels, ligaments loosen, fat pads atrophy and migrate, and skin loses collagen and elastin. GLP-1 therapy accelerates part of this process. Fat pads shrink quickly, especially in the mid-face, temples and around the eyes. Cheeks flatten, temples hollow and tear troughs deepen. With less internal volume, ligaments no longer hold skin taut and folds appear around the nose and mouth. The jawline loses definition, leading to early jowling. These changes may occur in months rather than years, creating the impression of sudden ageing.
Some compartments deflate dramatically, while others are preserved. This uneven redistribution produces sudden shifts in contour. The changes may occur within months rather than years, creating the impression of premature ageing even as health improves.
Research is ongoing into whether GLP-1s exert a direct effect on adipocytes or whether this is a consequence of rapid systemic weight loss alone. Clinically, the effect is unmistakable. Patients often remark that they look more gaunt or drawn even as they feel healthier.
Why rapid weight loss alters the body
Skin remodels slowly. Collagen and elastin provide elasticity, but their architecture does not keep pace with sudden weight reduction. When weight loss is gradual, skin adapts. When it is rapid, it may not have sufficient time.
GLP-1 patients often notice looseness in the arms, sagging in the abdomen and laxity in the thighs. These effects are more pronounced after forty, when collagen production is already reduced. Clothing may fit awkwardly, and folds can even cause physical discomfort.
The psychological burden
Many patients expect improved health to be matched by a fresher appearance. When their reflection shows gauntness or sagging, the contrast can feel like betrayal. Patients struggle with the paradox of feeling younger but looking older. At our medical dermatology clinic on Harley Street, we address this explicitly during consultation. Explaining the physiology helps patients separate their achievement from its aesthetic side effects; these can then be managed in a structured way.
Why fillers alone are not the answer
It may seem obvious to replace lost volume with fillers, but fillers alone do not restore skin quality, ligament tension or muscle support. Adding filler without first addressing these factors risks puffiness or distortion, particularly in leaner faces. At Self London, injectables are considered only once weight is stable and skin has been strengthened. Used carefully and conservatively, they restore balance; they do not overinflate.
Why devices come first
Energy-based devices prompt the body to remodel its own tissue. They stimulate fibroblasts to produce new collagen and elastin, thicken the dermis and restore elasticity. Unlike injectables, they can treat both the face and the body. By first repairing the foundation, devices create the framework for natural results. Subtle volumisation with injectables is only introduced where truly needed.
Sofwave: restoring tension in the mid-dermis
Sofwave delivers focused ultrasound energy 1.5 mm into the dermis, stimulating fibroblasts to produce collagen and elastin. Over time, this restores firmness and lift, improves jawline definition, reduces early jowling, and tightens the brow and neck. On the body, Sofwave is effective for arms, abdomen and thighs. Downtime is minimal, and results build over several months as collagen remodels.
UltraClear: precision resurfacing
UltraClear is our fractional erbium 2910 nm platform. At superficial levels, it smooths texture and clears pigmentation; at deeper levels, it rebuilds dermal density. The high water absorption of its wavelength ensures accurate ablation with minimal thermal spread, making it safe across a broad range of skin types. For GLP-1 patients, UltraClear treats, in one system, both surface irregularities and deeper thinning, both of which can be exacerbated by deflation.
BBL HEROic and HALO: restoring tone and luminosity
As features slim, photodamage often becomes more visible; age spots, redness and dine telangiectasia can stand out against leaner contours. This is where light and laser skin treatments can help. BBL HEROic targets pigment and vessels, while HALO combines ablative and non-ablative wavelengths to refine surface texture and tone. Together they restore even colour and luminosity, helping patients look as healthy as they feel.
Pure Impact EMS: rebuilding muscle
GLP-1 therapy reduces lean muscle as well as fat. Less muscle means less support for skin and posture. Pure Impact EMS uses electromagnetic stimulation to induce supramaximal contractions in the core, glutes and thighs. This builds strength and contour beyond what voluntary training alone achieves during calorie deficit. For GLP-1 patients, restoring muscle is key to definition, posture and long-term confidence.
Timing interventions
- Early: Sofwave, UltraClear and Pure Impact can begin during active weight loss, helping skin and muscle adapt.
- Stabilisation: Injectables are delayed until weight has been stable for 3-6 months, when true deficits can be identified and treated conservatively.
- Maintenance: Device-based care continues to support skin quality and muscle tone long-term.
Patterns we observe in clinic
- Women in their forties: temple hollowing, under-eye shadows, mid-face flattening, early jawline laxity.
- Men: trunk and abdominal laxity, sometimes chest or arm changes.
In both groups, distress is driven less by weight loss and more by a sudden change in appearance.
When surgery is appropriate
Devices achieve much, but not everything. For significant abdominal folds, severe lower-face descent or redundant arm skin, surgery may be more effective. Our role is to prepare tissue with non-invasive device treatments that improve vascularity and dermal quality, and to maintain results afterwards. Patients value clarity on when surgery is a better approach than investing time and money in interventions that are fundamentally incapable of addressing the issues.
The Self London protocol
Our philosophy is simple: restore biology before adding volume. We begin with Sofwave to strengthen collagen, UltraClear for resurfacing and to rebuild density, BBL and HALO to refine tone, and Pure Impact to reinforce muscle. Only once the foundation is secure do we add injectables, carefully and conservatively.
Results do not come from devices alone but how they are used; the same device in different hands can produce very different outcomes. At Self London, protocols are designed by consultant dermatologists using medical expertise, laser science and functional health. Treatments are calibrated to the individual, sequenced appropriately and adjusted as needed. Devices are chosen for their evidence base and versatility across diverse skin types. The outcome is not trend-driven but scientific, safe, and natural.
Final thoughts
GLP-1 therapies are one of the most important medical advances of recent years. They extend life and restore health, yet they can also cause hollowing, sagging and changes that unsettle patients.
These effects are not inevitable. With a device-first approach, Sofwave, UltraClear, BBL HEROic, HALO, and Pure Impact, appearance can be realigned with health. Injectables are used only when needed, to restore balance.
At Self London, our role is to ensure that weight loss not only transforms health but supports confidence in face and body too.
Frequently asked questions about Ozempic face and GLP-1 weight loss
What is Ozempic face?
It is the visible effect of rapid fat loss on the face: hollowing, sagging, and loss of support. It is not a medical term but describes a recognisable pattern.
Does everyone on GLP-1 medication get facial ageing?
Not everyone. The degree varies with age, skin type, genetics, and the amount and speed of weight loss.
Why not just use fillers?
Fillers do not restore collagen, ligament tension, or muscle. They are considered only after skin and structure are rebuilt, and are always used sparingly.
When should treatment begin?
Devices such as Sofwave, UltraClear, and Pure Impact can start during weight loss. Injectables are delayed until weight is stable for 3-6 months.
Is surgery ever a better option than device use?
Yes. Significant instances of abdominal folds, facial descent or excess skin may see better outcomes after surgery than via device treatments. While highly effective within their intended scope of performance, they cannot achieve unlimited results.
Book your consultation at Self London
If weight loss has left your face or body looking older than you feel, our device-first approach can restore balance. At Self London, we combine consultant-led expertise with advanced technologies to rebuild skin, muscle and confidence.
Book your consultation at our Harley Street clinic today and discover how our protocol can help you feel strong, healthy, and confident again.
Read our blog on ‘How to Keep Muscle While You Lose Weight‘
