Q&A: A Guide to Post–GLP-1 Facial Rejuvenation in the Aesthetic Clinic

As glucagon-like peptide-1 (GLP-1) receptor agonists continue to transform the weight management landscape, dermatologists and aesthetic clinicians are increasingly seeing patients concerned about the facial changes that can accompany rapid weight loss. With the growing popularity of these medications, concerns surrounding facial volume loss, skin laxity, textural changes, and altered facial balance have quickly become a new frontier in aesthetic dermatology. A recent paper, “Nonsurgical Aesthetic Treatment of the Face and Neck in GLP-1 Receptor Agonist Weight Loss Patients: Experience-Based Considerations,” offers practical insight into how clinicians can approach this evolving patient population through thoughtful, multimodal nonsurgical strategies.¹

Drawing from expert interviews with experienced dermatology and plastic surgery clinicians as well as a review of the limited but emerging literature, the authors describe a consistent pattern of aesthetic concerns associated with GLP-1–related weight loss and emphasize that treatment planning should extend well beyond simple volume replacement. Instead, they advocate for individualized, multimodal approaches that combine hyaluronic acid (HA) fillers, neuromodulators, collagen-stimulating injectables, energy-based devices, and skin-quality therapies to restore balance and support long-term outcomes. Regular follow-up, nutritional assessment, and patient education are also highlighted as critical components of care, particularly because ongoing weight loss may alter treatment durability and aesthetic outcomes over time.

In this Q&A, Dermatology Times sat down with study coauthor Anthony Rossi, MD, FAAD, FACMS, a double board-certified dermatologist and dermatologic surgeon at Memorial Sloan Kettering in New York, New York. He discussed how GLP-1–associated facial aging differs from traditional aging, why single-modality treatment often falls short, and the key strategies clinicians can use to restore facial harmony while avoiding an overfilled appearance.

Dermatology Times: How does weight loss with GLP-1 therapies differ from traditional weight loss in its impact on facial volume, wrinkles, and skin elasticity?

Rossi: The issue is usually not the GLP-1 medication itself; it is the speed and magnitude of weight loss. When patients lose weight rapidly, they can lose subcutaneous facial fat faster than the skin and supporting structures can adapt. That can create more sudden midface deflation, temple hollowing, under-eye shadowing, jowling, and accentuation of folds and wrinkles. They are also many times not only calorie deficient but also nutrient deficient, giving them poor skin quality.

With traditional, slower weight loss, the skin often has more time to remodel. With GLP-1–associated weight loss, a patient may look healthier systemically but feel that their face suddenly looks older, more tired, or less supported. This pattern has become predictable now: midface volume loss, temple and infraorbital hollowing, increased laxity, wrinkles, folds, and reduced skin quality.

This understanding emphasizes the specific considerations clinicians must have for this emerging patient demographic, which is further reinforced by the evidence-based guidance demonstrated in Allergan Aesthetics research.

MORE ON AESTHETICS

Dermatology Times: Why is a single-modality approach, like just using fillers, often insufficient for this patient group?

Rossi: This is not just a volume problem. It is a structural, textural, and skin-quality problem. Fillers can replace lost volume, but they do not fully address laxity, collagen depletion, crepiness, dyschromia, or dynamic wrinkles. They also don’t replace the strong influence that native fat adipose cells have on skin quality.

For patients taking GLP-1s, I think of treatment in layers: Restore support where it was lost with deeper structural filler, stimulate collagen where the skin has become lax with energy-based devices, soften dynamic movement with Botox Cosmetic neuromodulation, and improve skin quality with lasers, energy-based devices, resurfacing, and medical-grade skin care. If you only fill, you may make the face look heavier or puffy without actually improving the underlying skin envelope.

Dermatology Times: How do HA fillers and neuromodulators complement each other differently in a patient on a GLP-1 compared to a standard-aging patient?

Rossi: In a standard-aging patient, we are often treating gradual bone remodeling, fat pad descent, collagen decline, and expression lines over time. In a [patient using a] GLP-1, the change may be more abrupt, and there is often a sharper contrast between their prior facial fullness and their current deflated appearance.

HA fillers can be useful to restore strategic support in areas such as the lateral cheek, preauricular region, temples, jawline, and sometimes the tear trough region, but they have to be used conservatively and anatomically. Neuromodulators, meanwhile, help reduce repetitive muscle movement that can make already-thinner skin crease more visibly, especially in the forehead, glabella, crow’s-feet, platysma, and perioral region.

The key difference is that in patients on GLP-1s, fillers are not just “anti-aging”; they are often used to restore facial harmony after rapid fat loss. Neuromodulators help prevent the deflated skin envelope from folding and etching further.

Dermatology Times: With significant volume loss in the midface and temples, how do clinicians avoid creating a puffy look while trying to restore what was lost?

Rossi: The biggest mistake is chasing every hollow with filler. That is how patients end up overfilled but not truly rejuvenated. The goal is not to refill the face to its previous weight; it is to restore proportion, light reflection, and support in this new frame.

I usually think in terms of structure first: lateral cheek support, temple contour, jawline balance, and skin tightening. Product choice matters. Placement matters. Depth matters. A small amount of filler placed strategically can often do more than larger volumes placed superficially.

Interested in GLP-1s? Read our April cover story featuring Karan Lal, DO, MS, FAAD.

Reference

1. Moradi A, Denkova R, Holcomb K, Rossi A, Ashourian N. Nonsurgical aesthetic treatment of the face and neck in GLP-1 receptor agonist weight loss patients: experience-based considerations. Aesthet Surg J Open Forum. 2026;8:ojag011. doi:10.1093/asjof/ojag011