The increasing use of GLP-1 receptor agonists for obesity and metabolic disease has led to a recognisable clinical phenotype commonly termed “Ozempic face.” This presentation is characterised by midface deflation, periorbital hollowing, mandibular contour changes, dermal thinning, and increased skin laxity. While rapid adipose reduction is the primary driver, emerging mechanistic insights suggest a more complex biological interplay.

Experimental data indicate that GLP-1 receptor agonists may influence adipocyte-derived stem cell (ADSC) metabolism, potentially reducing glucose uptake and impairing differentiation into fibroblasts and preadipocytes. This may attenuate collagen, elastin, and hyaluronic acid synthesis, thereby compounding structural fat loss. In peri- and post-menopausal patients, these changes may be amplified: oestrogen decline is associated with accelerated collagen degradation, reduced fibroblast activity, diminished dermal thickness, and impaired extracellular matrix (ECM) maintenance. The combination of hormonal collagen loss and rapid fat depletion may therefore create a synergistic acceleration of visible facial ageing.

Management requires a staged, mechanism-based approach rather than reactive volumisation. Clinical guidelines include early patient counselling at GLP-1 initiation; assessment of weight-loss trajectory and hormonal status; prioritisation of dermal optimisation using regenerative injectables (e.g., polynucleotides, PLLA, CaHA) in patients with significant dermal compromise; conservative restoration of structural support with deep-plane hyaluronic acid fillers; and adjunctive intradermal hydration therapies and energy-based devices where indicated. Overcorrection should be avoided, particularly in deflation-dominant faces.

As GLP-1 therapies become increasingly prevalent, aesthetic practitioners must integrate metabolic and hormonal understanding into consultation frameworks. “Ozempic face” represents a paradigm shift toward regenerative, biology-informed aesthetic strategies tailored to midlife skin physiology.