Dermal fillers for Ozempic face have become increasingly sought after as GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) gain popularity for weight management in the UK. Rapid weight loss from these medications can lead to facial volume depletion, hollowing, and sagging—colloquially termed 'Ozempic face'. Dermal fillers offer a non-surgical solution to restore lost facial volume, recreate youthful contours, and address hollowing in the cheeks, temples, and mid-face. This article examines how dermal fillers work for facial volume restoration, the types available, safety considerations, and alternative approaches for managing facial changes following significant weight reduction.

What Is Ozempic Face and Why Does It Occur?

'Ozempic face' is a colloquial term that has emerged to describe facial volume loss and sagging skin observed in some individuals using GLP-1 receptor agonists such as semaglutide or tirzepatide. In the UK, semaglutide is licensed as Ozempic for type 2 diabetes management and as Wegovy (2.4mg) for weight management in adults with obesity. Tirzepatide (Mounjaro) is currently licensed for type 2 diabetes.

The mechanism behind facial changes relates primarily to rapid and substantial weight reduction rather than a direct pharmacological effect of the medication on facial tissues. There is currently no evidence in UK product information (SmPCs) of a direct pharmacological effect on facial fat; changes are likely due to weight loss itself. When individuals lose considerable weight—particularly at an accelerated rate—subcutaneous fat deposits throughout the body, including the face, diminish. The face contains distinct fat compartments that provide structural support and youthful contours. As these fat pads shrink, the overlying skin may not retract sufficiently, especially in older adults or those with reduced skin elasticity, resulting in hollowing of the cheeks, temples, and under-eye areas, alongside increased prominence of nasolabial folds and jowls.

It is important to emphasise that similar facial volume depletion can occur with any significant weight reduction, whether achieved through bariatric surgery, calorie restriction, or other weight loss interventions. The term 'Ozempic face' reflects the popularity of these medications rather than a unique adverse effect. Evidence regarding these changes is mainly observational, and individual results vary considerably. Factors such as age, genetics, baseline facial fat distribution, rate of weight loss, and skin quality all influence the extent of facial changes experienced during weight reduction therapy.

How Dermal Fillers Can Address Volume Loss from Weight Loss Medications

Dermal fillers offer a non-surgical approach to restoring facial volume and contour in individuals who have experienced facial hollowing following significant weight loss. These injectable treatments work by replenishing lost volume in specific facial compartments, thereby recreating the structural support that diminishes when subcutaneous fat is depleted.

The primary mechanism involves the strategic placement of gel-like substances beneath the skin to:

• Restore volume in hollowed areas such as the cheeks (malar region), temples, and mid-face

• Improve facial contours by re-establishing youthful proportions and reducing the appearance of sagging

• Soften deep folds including nasolabial lines and marionette lines that become more pronounced with volume loss

• Enhance structural support for overlying skin, creating a lifting effect without surgery

Treatment approach typically involves a comprehensive facial assessment by a qualified practitioner—ideally a medically qualified prescriber (doctor, dentist, nurse or pharmacist independent prescriber) with specialist training in aesthetic medicine. The practitioner evaluates facial anatomy, identifies areas of volume depletion, and develops an individualised treatment plan. This may involve treating multiple facial zones in a staged approach to achieve natural, harmonious results.

Results from dermal filler treatments are typically visible immediately, though final outcomes become apparent once any initial swelling subsides, usually within 1–2 weeks. The longevity of results varies depending on the filler type, treatment area, individual metabolism, and lifestyle factors, generally lasting between 6–24 months. Maintenance treatments are required to sustain results.

Patient selection and timing are crucial—dermal fillers work best for volume restoration rather than addressing significant skin laxity. For optimal and more predictable results, it is generally advisable to wait until weight has stabilised before undergoing volumisation treatments. Treatment is tailored to individual needs, may require multiple staged sessions, and results vary significantly based on individual factors.

Types of Dermal Fillers Used for Facial Volume Restoration

Several categories of dermal fillers are available in the UK, with hyaluronic acid (HA) fillers being the most commonly used for facial volume restoration following weight loss. Understanding the different types helps patients make informed decisions in consultation with their practitioner.

Hyaluronic Acid Fillers

These represent the gold standard for facial volumisation and include brands such as Juvéderm, Restylane, and Teosyal. Hyaluronic acid is a naturally occurring substance in human skin that attracts and retains water, providing hydration and volume. Key advantages include:

• Reversibility: HA fillers can be dissolved using hyaluronidase enzyme (a prescription-only medicine) if results are unsatisfactory or complications arise

• Biocompatibility: Lower risk of allergic reactions as HA is naturally present in the body

• Versatility: Available in various viscosities and particle sizes for different facial areas and depths

• Natural results: Integrate well with facial tissues when properly placed

Different HA formulations are designed for specific purposes—lighter products for superficial lines, whilst more robust, cohesive gels are used for deep volumisation in the cheeks and mid-face.

Calcium Hydroxylapatite Fillers

Products such as Radiesse contain calcium-based microspheres suspended in a gel carrier. These provide immediate volume whilst stimulating collagen production over time, offering both instant and progressive improvement. They are particularly suited to deeper facial volumisation and can last 12–18 months. Importantly, these fillers cannot be dissolved with hyaluronidase and should be avoided in high-risk areas such as the lips and tear troughs.

Poly-L-Lactic Acid (PLLA)

Sculptra works differently by stimulating the body's own collagen production gradually over several months. Rather than providing immediate volume, PLLA requires multiple treatment sessions and delivers subtle, progressive improvement over 3–6 months, with results potentially lasting beyond two years. This option suits patients seeking gradual, natural-looking restoration. Like CaHA, PLLA is not reversible and requires careful patient selection.

Selection considerations include treatment goals, budget, desired longevity, individual facial anatomy, and the trade-off between longevity and reversibility. Patients should ensure their practitioner uses CE/UKCA-marked products from reputable manufacturers and has specific experience with the chosen product, particularly for treatments in anatomically complex areas such as the mid-face, temples, and tear troughs.

Safety Considerations and Potential Risks of Dermal Fillers

Whilst dermal fillers are generally considered safe when administered by appropriately qualified practitioners, patients must understand potential risks and safety considerations before proceeding with treatment.

Regulatory Framework in the UK

In the UK, the regulatory status of dermal fillers depends on their intended purpose. Those with a medical purpose are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) as medical devices, while those used purely for cosmetic purposes have historically had less regulatory oversight. However, a forthcoming licensing scheme for non-surgical cosmetic procedures under the Health and Care Act 2022 will strengthen regulation.

Importantly, it is illegal to provide cosmetic fillers to anyone under 18 years of age under the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021.

Patients should ensure their practitioner is:

• A registered healthcare professional (doctor, dentist, nurse, or pharmacist prescriber)

• Appropriately trained in facial anatomy and aesthetic injection techniques

• Able to manage complications, including vascular occlusion emergencies

• Has immediate access to hyaluronidase (a prescription-only medicine required for dissolving HA fillers in emergencies)

• Working in a clinical environment with appropriate emergency equipment

Common Side Effects

Most patients experience mild, temporary reactions including:

• Swelling, redness, and tenderness at injection sites (typically resolving within 2–7 days)

• Bruising (more common in certain facial areas and in patients taking anticoagulants)

• Temporary lumps or asymmetry

• Mild discomfort during and after treatment

Serious Complications

Though rare, serious adverse events can occur:

• Vascular occlusion: Accidental injection into or compression of blood vessels can compromise blood supply, potentially causing tissue necrosis or, extremely rarely, vision loss. This constitutes a medical emergency requiring immediate intervention with hyaluronidase (for HA fillers). If visual symptoms occur, call 999 or attend A&E immediately

• Infection: Bacterial infection at injection sites requires prompt antibiotic treatment

• Granulomas/biofilms: Inflammatory nodules may develop weeks to months post-treatment

• Allergic reactions: Rare but possible, particularly with non-HA fillers

• Herpes simplex reactivation: In susceptible individuals, particularly with perioral treatments

Patient Safety Advice

Patients should contact their practitioner immediately if they experience severe pain, skin colour changes (blanching or purple discolouration), or signs of infection following treatment. For any visual disturbances or significant facial symptoms, seek emergency medical care (999/A&E) without delay. Choosing an experienced, medically qualified practitioner significantly reduces complication risks and ensures appropriate management if problems arise.

Alternatives to Dermal Fillers for Managing Facial Volume Loss

For individuals experiencing facial volume loss following significant weight reduction, several alternatives to dermal fillers exist, each with distinct mechanisms, benefits, and limitations.

Gradual, Moderate Weight Loss

The most effective preventative approach involves slower, controlled weight reduction (typically 0.5–1 kg per week as recommended by NHS and NICE guidance). This allows skin greater opportunity to adapt and retract, potentially minimising facial volume loss. Patients using GLP-1 receptor agonists should work closely with their prescribing clinician to optimise dosing and weight loss trajectory.

Lifestyle Measures and Multidisciplinary Support

Consultation with a dietitian and physiotherapist can help optimise nutrition and exercise during weight loss. Adequate protein intake and resistance training may help preserve lean muscle mass and potentially improve skin tone. NHS weight management services can provide structured support for those eligible.

Skincare and Non-Invasive Treatments

Whilst these cannot replace lost volume, they may improve skin quality and appearance:

• Topical retinoids: Prescription tretinoin or over-the-counter retinol can improve skin texture and stimulate collagen production

• Radiofrequency or ultrasound devices: Treatments such as Thermage or Ultherapy deliver controlled heating to deeper skin layers, stimulating collagen remodelling and providing modest skin tightening

• Microneedling with radiofrequency: Combines collagen induction with thermal energy for skin rejuvenation

Fat Transfer (Autologous Fat Grafting)

This surgical procedure involves harvesting fat from one body area (typically abdomen or thighs) and injecting it into the face. Advantages include using the patient's own tissue and potentially permanent results (though some resorption occurs). However, it requires surgery under local or general anaesthesia, carries surgical risks, and results can be unpredictable.

Surgical Options

For significant skin laxity alongside volume loss, facelift surgery (rhytidectomy) may be more appropriate than fillers alone. This addresses both excess skin and repositions deeper facial structures, providing comprehensive rejuvenation. Patients should verify that their surgeon is on the General Medical Council's Specialist Register and, ideally, a member of BAAPS or BAPRAS. In England, cosmetic surgery should take place in CQC-registered facilities.

Combination Approaches

Many patients achieve optimal results through combining treatments—for example, modest filler for volume restoration alongside skin tightening procedures. A comprehensive consultation with a qualified aesthetic practitioner or plastic surgeon helps determine the most appropriate individualised treatment strategy based on the degree of volume loss, skin quality, patient goals, and budget considerations.

Frequently Asked Questions