Medication-Assisted Weight Loss and the Face: What the Evidence Shows

Medication-Assisted Weight Loss and the Face: What the Evidence Shows

Weight management is a clinical topic that has received considerable attention in recent years, particularly as prescription medicines have become more widely used under medical supervision.

For some individuals, changes in body weight can also be accompanied by changes in facial appearance. Understanding what the evidence says, and what it does not say, supports more informed decisions about skin health.

What Is Medication-Assisted Weight Loss?

Medication-assisted weight loss refers to the use of prescription medicines, prescribed and supervised by a registered medical practitioner, as part of weight management. These medications may influence appetite, the rate of gastric emptying, or how the body regulates blood sugar. They are not available over the counter and are not appropriate for everyone.

In Australia, prescription medicines of this kind fall under the regulation of the Therapeutic Goods Administration (TGA) and require a valid prescription from a qualified medical practitioner.

Weight Loss and the Face: What Does the Research Show?

Facial fat is not simply stored in one uniform layer. It is organised into distinct anatomical compartments, both superficial and deep, that contribute to the three-dimensional structure and contour of the face. When body weight decreases, facial fat can also decrease. This is not specific to any one method of weight loss; it has been observed following dietary change, bariatric surgery, and medication-assisted weight loss alike.

A 2024 systematic review published in Aesthetic Surgery Journal Open Forum examined soft tissue facial changes following significant weight loss across multiple studies. The review found that the most consistent changes included fat loss in the mid-cheek region, deepening of the nasolabial folds, and increased skin laxity, particularly in the lower face and neck. The authors noted that these changes were related to fat reduction in both superficial and deep compartments of the face.

Separately, research published in Plastic and Reconstructive Surgery provided direct evidence that measurable fat loss occurs in the midface over time, with reductions observed in both superficial and deep facial fat compartments, contributing to changes in facial contour that are distinct from skin laxity alone.

Studies examining the use of GLP-1 receptor agonists specifically have noted changes along the temples, the peri-orbital region, and the mid-facial region. One objective volumetric analysis found notable reductions in both the superficial temporal fat pad and the cheek fat pad in individuals using these medications.

It is important to note that this area of research is still developing. The studies available vary in methodology and scale, and the authors of the systematic review advocate for further longitudinal research to better understand the relationship between medical weight loss interventions and facial morphology.

Which Areas of the Face Are Most Commonly Affected?

Based on the available evidence, the areas most frequently observed to change with significant weight loss include the midface and cheeks, where fat pad reduction may contribute to a flatter appearance or deepening of the folds running from the nose to the corners of the mouth; the temples, where hollowing may become more visible as the superficial temporal fat pad reduces; and the periorbital region, the area around the eyes, where changes in surrounding fat can affect how the skin appears.

These changes are not uniform across individuals. Age, skin quality, rate of weight loss, baseline facial anatomy, and other health factors all influence how, and to what degree, facial changes may present.

The Role of Skin Quality

Skin quality is influenced by a range of factors, including nutrition, hydration, collagen density, and overall health. During periods of weight change, some of these factors may also shift. Collagen and elastin — structural proteins that contribute to skin firmness and elasticity — can be affected by nutritional status and by the rate at which changes occur. Rapid changes may allow less time for the skin to adapt, which some researchers suggest can make volume changes more apparent.

Maintaining adequate nutrition, hydration, and general health during any period of weight change supports overall skin and tissue health, though this cannot prevent all changes associated with significant fat loss.

Individual Variation

Not every person who loses weight will notice significant facial changes. The degree to which these changes are visible depends on a number of individual factors, including age and baseline skin laxity, rate of weight loss, genetic factors affecting fat distribution and skin elasticity, and overall health and nutritional status. Some individuals may notice minimal change; others may find the shift in facial appearance more marked. This variability is relevant when thinking about skin health holistically.

A Note on Consultation

While some individuals may notice changes in facial aesthetics during their weight loss journey—particularly with the use of weight loss medications—the overall health benefits of weight reduction far outweigh these concerns. Improvements in metabolic health, cardiovascular risk, and overall wellbeing should always remain the priority.

If appropriate, a discussion with our team may help explore individual considerations in more detail. Our team might have an important role supporting you during you weight loss journey and the changes it may have on your face and body. Any assessment at Dr Wod Cosmetic Clinic begins with understanding your health background, current circumstances, and what is relevant to you specifically.

Weight loss should be a positive, empowering experience—and with the right support, you can feel just as good as you look throughout the process.

This information is general in nature and does not replace a personalised medical assessment. Individual needs, circumstances, and responses can vary, and not all options are suitable for everyone.

Dr Wod | MED0001783298 | Specialist General Practitioner (FRACGP)

References

Jafar AB, Jacob J, Kao WK, Ho T. Soft tissue facial changes following massive weight loss secondary to medical and surgical bariatric interventions: a systematic review. Aesthetic Surgery Journal Open Forum. Published online August 22, 2024. doi:10.1093/asjof/ojae069

Morgan A et al. Facial aging: a quantitative analysis of midface volume changes over 11 years. Plastic and Reconstructive Surgery. 147(2):319–327, February 2021. doi:10.1097/PRS.0000000000007518

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FAQ

How does muscle relaxing toxin injection work?

It works by relaxing facial muscles, thereby temporarily reducing and smoothing dynamic frown lines and wrinkles, i.e. those lines caused by movement of the muscles.

Who should not take botulinum toxin?

  • Had an allergic reaction to any of the botulinum toxin products or their ingredients.
  • Have a skin infection at the planned injection site.
  • A disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease], myasthenia gravis or Lambert-Eaton syndrome).
  • Had any side effect from the product product in the past.
  • A breathing problem, such as asthma or emphysema.
  • Swallowing problems.
  • Bleeding problems.
  • Plans to have surgery.
  • Had surgery on your face.
  • Weakness of your forehead muscles, such as trouble raising your eyebrows.
  • Drooping eyelids.
  • Any other change in the way your face normally looks.
  • Are pregnant or plan to become pregnant.
  • Are breast-feeding or plan to breastfeed.

Do treatment results differ?

Yes, individual results may vary. To get the best results, it's important to go to a doctor who is experienced in administering these injections.

What conditions can be treated effectively with laser therapy?

  • Vascular lesions

Well-defined lesions (abnormalities of the tissue, in this case the skin) that contain blood are usually amenable to laser therapy. These include unwanted blood vessels (‘broken capillaries’) on the face, and birth marks such as port wine stains. Depending on the size of the lesion, the number of laser treatments that are needed can range from 2 to 10 or more.

Laser therapy is also sometimes used for small varicose veins and spider veins.

  • Pigmented lesions

Pigmented lesions that can be treated include: freckles; solar lentigos (liver, or age, spots); flat, pigmented seborrhoeic keratoses (age warts); and café au lait spots (light-tan spots). Laser treatments for pigmented lesions are generally spaced 6 or more weeks apart, to allow your body to get rid of the dispersed pigment.

  • Tattoos/Not currently available

The principle of laser tattoo removal is basically the same as that of the removal of pigmented lesions, but the wavelength of the light beam needs to vary depending on the different ink pigments used in the tattoo. In general, homemade Indian ink tattoos and black tattoos respond most readily to laser removal. White tattoos do not usually respond to treatment. Red is relatively easy to remove, while yellow, orange and green are more difficult.

Skin that has been stained from nasal piercing or from iron injections also usually responds well to laser treatment.

  • Hair removal

Laser-assisted hair removal is both efficient and long term. It works best on thicker, darker hairs, as these hair follicles absorb more light than do smaller, paler hair follicles. Most people find that the amount of hair is reduced by 70 per cent or more after the course of treatment. Laser hair removal also avoids the possibility of ingrown hairs. Sweating changes are sometimes noticed in the treated area.

  • Signs of ageing

Laser resurfacing is used to help reverse the signs of ageing caused by sun damage. Signs of ageing include fine wrinkles and crinkly skin. Resurfacing is also useful in reducing the appearance of acne scars. Following treatment, your skin often takes several weeks to recover.

Laser resurfacing is a safer and more refined procedure than it used to be, but it is still not recommended for people with olive or pigmented skin because of the possibility of uneven skin tone or loss of colour from the skin after treatment.

  • Scars

Whether scars of previous surgery, acne or post burn scar, can all be minimised by laser resurfacing, CO2 fractionated laser is in particular useful for these conditions.

Who can be a good candidate for PDO Lift?

PDO procedures are safe for adults with mild to moderate skin laxity, who keep up with healthy lifestyles and have maintained their weight for at least three months.

Who can be a good candidate for Double chin Treatment ?

The best candidate is an adult 18 years or older with moderate to severe fat beneath the chin. You might not be a good candidate if you have had or are planning to have facial surgery, if you have trouble swallowing, are pregnant or nursing, or have an infection or medical condition in or near the planned injection site.