Weight loss from GLP-1 receptor agonists and facial ptosis: Specific mechanism or epiphenomenon of weight loss? A critical review
DOI:
https://doi.org/10.14295/bjs.v6i3.948Keywords:
GLP-1 receptor agonists, semaglutide, facial aging, ptosis, Ozempic faceAbstract
The expanding use of glucagon-like peptide-1 receptor agonists (GLP-1RA) for the treatment of type 2 diabetes mellitus and obesity has made a set of facial aesthetic changes popularly known as “Ozempic face” clinically common, characterized by volume loss, deepening of folds, and soft-tissue ptosis. A central controversy persists regarding causality, however: do these changes result from a specific pharmacological effect of the GLP-1 pathway on dermal cells, or are they merely an epiphenomenon of the magnitude and speed of weight loss, independent of the drug class? This narrative critical review synthesizes the available evidence on epidemiology, clinical presentation, molecular and tissue mechanisms, and aesthetic management options, with emphasis on the methodological gaps that prevent a definitive causal attribution. We conclude that the association between GLP-1RA and accelerated facial ptosis is robust and reproducible, but the existence of a receptor-specific mechanism remains a biologically plausible, still-unproven hypothesis, given the absence of studies that control for the rate of weight loss as a confounding variable.
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Copyright (c) 2027 Ana Beatriz Neves Felix, Camila de Oliveira Zendram, Isabela Cristina de Pinho Rosa, Amir Horiquini Barbosa, Érica Ferrari Calissi
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