Weight-loss injections and facial sagging: signs and treatments

Why it happens

Weight-loss injections, such as Ozempic and Wegovy (semaglutide) and Mounjaro (tirzepatide), act on appetite and satiety and lead to significant weight loss within a few months. This weight loss brings important health benefits, but it also changes the face.

Facial fat is distributed in compartments that give volume to the temples, cheeks, the area around the eyes and the jawline. When these compartments shrink quickly, the skin loses the support it had: the cheeks drop, the folds deepen and the face becomes thinner and more hollow. If the skin already has less collagen and elastin, due to age or sun, it cannot retract at the same speed, and laxity becomes more evident.

Signs on the face

• A thinner face, with a tired or older look
• Volume loss in the temples and cheeks
• Deeper dark circles and hollow eyes
• Deeper folds, such as nasolabial folds and marionette lines
• Sagging cheeks and loss of jawline definition
• Excess skin under the chin and on the neck
• Thinner skin, with more fine wrinkles and less glow

These signs usually appear during the first months of weight loss and become more evident when the weight loss is large or rapid. Weight loss can also accentuate laxity on the body, arms, abdomen and thighs, a topic covered on the body skin laxity page.

How the evaluation is done

The dermatologist assesses the face from different angles, the thickness and quality of the skin, the volume loss in each region and the degree of tissue sagging. They also consider the phase of weight loss, whether the weight is still dropping or has stabilized, and the patient's expectations. This analysis shows which layer has changed most in each case, whether the skin, volume or support, and guides the choice and order of treatments.

Recommended treatments

In mild to moderate cases, non-surgical treatments act on different layers of the face and can be combined.

• Hyaluronic acid fillersRestores the volume lost in the temples, cheeks, under-eyes and folds.
• Collagen biostimulatorsStimulate collagen production and improve the thickness and firmness of the facial skin.
• Harmonyca (hyaluronic acid and calcium hydroxylapatite)Support and volume with collagen stimulation in the midface and facial contour.
• Ultraformer® MPTMicrofocused ultrasound for support of the face, double chin and neck.
• Evolla® MPRadiofrequency for facial skin firmness, with no downtime.
• Profhilo (hyaluronic acid)Deep hydration and improved quality of thin facial and neck skin.
• SkinboostersSkin hydration and glow, with improvement of fine wrinkles.
• PDO threadsLifting threads to reposition the cheeks and contour, in selected cases.

Combined treatments

The most common combination pairs volume restoration with fillers in the areas that lost the most fat, such as the temples and cheeks, with a biostimulator, which improves skin thickness and firmness, and a technology such as Ultraformer® for support of the contour, double chin and neck. The plan and the order of procedures are defined at the evaluation, according to the phase of weight loss.

Care during weight loss

• Use weight-loss injections only with medical indication and follow-up.
• Follow the dietary guidance, paying attention to protein intake.
• Use sunscreen every day, since the sun speeds up the loss of facial collagen.
• Keep a skin care routine with adequate hydration.
• See a dermatologist early, when the first signs appear, to plan facial care throughout the weight loss.

When to see a dermatologist

See a dermatologist if you notice a thinner or more tired face, deeper folds, loss of jawline definition or excess skin under the chin during or after weight loss with these injections.