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In this episode of Skinside Out, Dr. Zain Husain, MD, Heather Murray, PA-C, and aesthetician Courtney Carroll, LE talk about the emerging phenomenon of 'Ozempic Face,' detailing the effects of GLP-1 medications on facial volume and skin quality. They discuss a comprehensive range of modern aesthetic solutions—from dermal fillers and biostimulatory products to lasers and energy-based devices—to restore a youthful, natural appearance. Join us to learn how to combine different treatments effectively and maintain your results with proper skincare at home.
00:00 Introduction to Skin Side Out
00:34 Understanding Ozempic Face
01:07 Impact of Rapid Weight Loss on Facial Volume
03:23 Restoring Volume: Dermal Fillers
07:06 Advanced Treatments: Biostimulatory Products
14:31 Innovative Techniques: PRP and Exosomes
16:06 Laser and Energy-Based Devices
20:15 Combining Treatments for Best Results
23:45 Conclusion and Final Thoughts
Creators and Guests
Host
Host
What is Skinside Out?
Welcome to Skinside Out, where science meets beauty, the ultimate dermatology podcast! Dive deep into the fascinating world of skin health with expert insights, evidence-based discussions, and myth-busting truths. Each episode explores the medical, cosmetic, and surgical aspects of dermatology, while keeping you informed about trending skincare topics. Whether you’re a skincare enthusiast, medical professional, or just curious about how to achieve your best skin, Skinside Out is your go-to resource for staying informed and inspired.
Dr. Zain Husain, MD: [00:00:00] [00:00:15] Welcome to another episode of Skin Side Out where Science meets Beauty. I'm your host, Dr. Zane. Um, and I'm here with Pa Heather, and my aesthetician [00:00:30] Courtney. I. Today we're gonna be talking about a hot topic. Um, you know, everyone's talking about.
Um, the GLP ones and you know, how they're leading to massive weight loss, but its impact on facial volume and hollowing out, also known as the ozempic face. [00:00:45] So I'm sure you guys have all seen that in the media. Um, as you can see in these images, these are all well-known celebrities who have been on GLP ones.
These medications that lead to rapid weight loss, and you can kind of see the hollowed deflated look. [00:01:00] Um, that kind of almost makes them a little, you know, sickly looking.
Courtney Carroll, LE: This needs a jump scare warning.
Dr. Zain Husain, MD: Yeah. So I think this is a really, um, you know, hot topic because so many patients are on it. We've had many of our patients come in with, you know, [00:01:15] great weight loss results, but have had a lot of hollowing effects.
Heather Murray, PA-C: People that are on these medications are investing in their selves. They're trying to feel more self-confident and better in their skin, and a lot of times this ozempic face, um, [00:01:30] leaves you looking and feeling, feeling older and tired than you actually are.
Courtney Carroll, LE: Sometimes the fat in our, you know, in our cheeks especially, that's what gives that youthful appearance. So when you're losing weight so [00:01:45] rapidly and you lose the fat in there, it creates almost this like skeleton, you know, you're losing fat in your temples. You've got the js going on, um, wrinkling around the, the mouth and around the eyes.
So it just, um, and even skin texture. I mean, you [00:02:00] think of like the, the dullness in the skin that can happen. Sometimes from not getting the right nutrients if you know you're changing your diet or things like that. So it can have some pretty prominent features.
Dr. Zain Husain, MD: Yeah, absolutely. I mean, those fat pads are really important for our facial [00:02:15] structure and youthfulness.
Um, and we see shrinking of those fat pads as we age. That's normal. We see that all the time. And that leads to, you know, those jowls and, you know, these deflated looks over, um, you know, the lifespan, but. [00:02:30] When we see these patients on GLP ones, we're seeing really rapid, um, loss of those fat pads, and it's almost to a different extent than we see with normal aging.
So there have been studies that are really looking into how these [00:02:45] medications are impacting those fat cells, specifically in the phase and leading to this hollowed appearance.
Courtney Carroll, LE: Just the overall quality of the skin can really be impacted, um, with, you know, lack of hydration and then just that overall, you know, glow.
Heather Murray, PA-C: And we definitely have tools to [00:03:00] help you reveal your glow. Um, so we did wanna touch on, you know, ways that you can restore volume, especially if you're on these GLP one medications and noticing that. Volume loss. So just to kind of break it down and give you a [00:03:15] little bit of overview, um, we're gonna talk about a variety of ways to treat volume loss and skin laxity and give you that natural and youthful appearance.
So first we'll talk about dermal fillers. This can include Restylane, Juvederm, um, RHA, [00:03:30] the list goes on. But we're also gonna touch on Biostimulatory products such as s Sculptra Radius. PRP and exosomes. Then we'll get into like lasers and energy based devices. So like CO2 [00:03:45] erbium laser, non-ablative fractional lasers, RF microneedling, and um, you know, see how that can help restore volume and collagen.
Courtney Carroll, LE: Yeah, and we'll touch a little bit on you know, not even so [00:04:00] much skin laxity, which of course is a problem, but, um, as mentioned, skin texture, tone quality. All the things that come together to give us that. Space that we want.
Heather Murray, PA-C: Yeah. And I think a lot of, especially the laser and energy based devices, they're not [00:04:15] necessarily gonna give you that volumization.
Mm-hmm. But they're gonna help stimulate collagen. And it might be, um, we'll talk later about how to combine different treatments, but really, if somebody doesn't necessarily need a lot of volume restored, but just needs a little bit of [00:04:30] tightening, then those are great options too.
Dr. Zain Husain, MD: Yeah, absolutely. Um, so I'm gonna start off with discussing fillers, um, you know.
Fillers have become very popular. Um, you know, with social media and with the various [00:04:45] offerings, um, that are available. There's so many fillers on the market. Mm-hmm. And they all have different properties. So what we're using fillers, traditional hyaluronic, acid-based fillers, we're actually injecting it in areas to restore volume.
So hyaluronic acid is a sugar molecule that [00:05:00] is actually in our skin, gives us buoyancy, volumization. Um, also gives a, its youthful glow and hydration. So we're injecting synthetic hyaluronic acid into various areas to re volumize, um, the face. [00:05:15] That includes the cheeks, the temples. We can also use it to restore volume in the jaw line.
Um, you know, those are the most common areas we typically, um, you know, focus on the under eyes. Yep. Under eyes and nasal labial folds. Um, so there are a lot of [00:05:30] options also using it for the lips. When we're looking at a patient, when I see a patient for a cosmetic consult, um, especially one who has had a lot of rapid weight loss, like with the GLP one, um, medication, um, I am looking at the areas where they [00:05:45] have lost the most volume and using these fillers to really kind of replenish that loss volume.
So, you know, whether I'm going into the temples, the cheeks, the nasal labia folds, the jawline. We're using various different fillers, which [00:06:00] have different properties to establish that youthful look in a natural way. So they all have different properties like I was mentioning. So like say something under the eyes in the Infraorbital hollows or the tear troughs.
I use a soft filler [00:06:15] such as Restylane L or a Bero that are really soft, smooth, and they don't give that tyle effect, that bluish hue that you can sometimes see. With poorly injected filler. Maybe it was the wrong product, not even the injection type, but [00:06:30] that's really important. Um, and for like areas like the cheeks, the temples, jawline, we want stronger, thicker, more dense, high G prime fillers to really help volumize and create structure.
and [00:06:45] softer areas like where there's more mobility and expression like around the mouth, um, with the nasal labial folds. So there's a lot of artistry and science behind these fillers, but we can really create a customized look for our patient that looks natural, restoring their [00:07:00] loss volume. So I do think that there's a lot of, um, opportunities to use hyaluronic acid based fillers in these patients.
I. However, you can also use, um, fillers such as Radius. Mm-hmm. Um, so a calcium hydroxyl appetite, it's a totally different type of filler. [00:07:15] Um, it's not hyaluronic acid based, and we inject this, um, in the skin and I love it for recreating structure on bony areas such as, you know, like the cheekbones, um, the jawline.
It's really, really nice for that. So I [00:07:30] do think that, you know, you can customize based on where you see the volume loss and really getting that natural look.
Courtney Carroll, LE: I'm glad you touched on that because I think a lot of people are under the impression that each filler is created equally and [00:07:45] filler is filler.
They have this concept that just filler is filler, and that's not necessarily the case. Um, there are different brands, so you know, through Allergan, through mers, um, these different companies and then the viscosity of the fillers vary. Mm-hmm. Vary [00:08:00] completely from product to product. Mm-hmm. So I think it's important that people know that.
Heather Murray, PA-C: I think also too, whether you're using cannula versus needle. Mm-hmm. So, Dr. Zane, do you wanna touch on the difference?
Dr. Zain Husain, MD: Yeah. So, um, traditionally we [00:08:15] have injected fillers with sharp needles like we do with many injections. Um, and, you know, that allows for precision. Um, it also allows us to kind of really know where we're injecting.
However that. Can also [00:08:30] lead to, you know, issues such as bruising. You can, you know, potentially, you know, hit structures such as nerves and um, you know, other, um, you know, items. So I do think that, you know. Although the needle offers [00:08:45] precision, you know, sometimes from a safety standpoint, I do sometimes prefer cannula.
Especially I love using it in Infraorbital hollows where, you know, we've reduced the risk of bruising, which can be pretty brutal, um, under the eyes, and also has a lesser risk of [00:09:00] getting into a blood vessel and can lead to vascular occlusion, which means that you get filler into a blood vessel, which then.
Basically blocks off oxygen and blood flow to that particular area of the skin as well as other, you know, tissues [00:09:15] there and can lead to death of that tissue. So, um, I feel a little bit more confident, um, especially in those high risk danger zones. Um, one, am I injecting,
Courtney Carroll, LE: what is cannula for those who don't know?
Yeah,
Dr. Zain Husain, MD: it's a good question. I should explain that. Um, so cannulas are [00:09:30] these blunt tip needles. So basically we use an introducer sharp needle. Where we create a little port and then we insert these longer blunt tip needles that can [00:09:45] manipulate through the tissue without severing, you know, blood vessels or other structures to kind of move them out the way.
'cause they're blunted. It really reduces the risk of you cannulating or getting into a blood vessel, which [00:10:00] reduces risk of vascular occlusion. Um, also helps me prevent bruising. So a lot of our patients appreciate that, but it does require a little bit of skill. There's a learning curve with it, but I do think that I.
Once you get the hang of it, it really offers a [00:10:15] great experience for the patient. 'cause usually less painful than repetitive sharp needles reduces the bruising, which can sometimes last for a week.
Heather Murray, PA-C: Yeah.
Dr. Zain Husain, MD: And also I love the safety profile, so I think patients feel more confident in an injector who has mastered that [00:10:30] technique.
And it's really catching on here in the us. I mean, I know that in Asia and in Europe. Cannulas have been around for a while and they are really, um, you know, advocated for over there and we're definitely seeing a lot more, um, injectors using cannula.
Heather Murray, PA-C: [00:10:45] Yeah, cannula is great. I do think these dermal fillers definitely have a.
Place for giving you that immediate result if you're trying to volumize. Um, you did talk about Radius, which, um, traditional radius can be used to give you that [00:11:00] immediate mm-hmm. Volumization. Um, but we'll kind of transition that into bio biostimulatory products so Radius can actually be used. To stimulate collagen as well.
So it's called hyper dilute dilute radius, um, which is what it means, um, [00:11:15] hyper dilute. So it has the benefit of stimulating collagen production over time. Um, radius is a non-inflammatory gel that mimics connective tissue and it adds volume, but it can also improve the skin structure, [00:11:30] laxity texture over months after the treatment.
Courtney Carroll, LE: I know we've been using a lot of s sculptra too. So, um, s Sculptra is another type of biostimulatory, um, it's poly l lactic, and so it actually uses an inflammatory response to [00:11:45] trigger the body's natural collagen process. Um, it's not something that's gonna be your quick fix. I tell patients all the time, this is something that's happening in your skin for the next few months.
That collagen production does take a little bit of time. So this is more of your [00:12:00] long-term answer, I think they say, I think we touched on it last time like a vial for every decade, something like that. Um, but you know, the nice part about the sculpture too, that I really like is that it's not only restoring the collagen and the volume, but it's helping to improve the [00:12:15] skin texture and the tone.
Um, so, you know, when people think of like that glass skin, I, I think that's where sculpture kind of has its niche where it's, it's multifunctional.
Heather Murray, PA-C: They sound very similar. Sculpture and radius. So like the biggest differences between [00:12:30] sculpture and radi, hyper dilute radius. Um, the mechanism of action we kind of touched on the radius is a non-inflammatory gel where a sculpture kind of uses that inflammatory response to stimulate collagen.
Um, the duration is a little bit different, hyper dilute [00:12:45] radius. Usually we tell people it lasts about a year. Um, could last about two years, but s Sculptra has that kind of a little bit longer efficacy of lasting up to two years. , the depth of injection does make a difference to, the aftercare [00:13:00] too is definitely plays a role. The s sculptra, you have a little bit more upkeep. You have to massage that area five times a day. 5, 5, 5, 5 times a day for five days, five minute sheets, chime.
just trying to, you know, clarify some of the differences. Yeah.
Dr. Zain Husain, MD: And I think with the [00:13:15] sculpture, I mean, a lot of people have heard about sculpture from the past and you know, they hear horror stories of these nodules. Yeah. And people are scared to do it. Um, that has all changed with the new dilution that we're doing.
So they're definitely more dilute. [00:13:30] Um, and we're seeing a less incidence of those inflammatory nodules that form, um, from s Sculptra. Many patients would be pleasantly surprised to maybe try it. Because it's not like what everyone's talking about, like from the past.
Courtney Carroll, LE: And [00:13:45] these products can be used more than, you know, just in the face.
Mm-hmm. We have the neck, the decollete, the hands sometimes, you know, during that weight loss journey. Butt. Butt. Yeah. Butt ex. I mean. Well, and that's important because when you're losing weight and depending on what you're doing to lose that weight. [00:14:00] Um, you know, let's say you're just running or doing cardio and you're not doing a lot of that weightlifting.
Um, yeah. Some of those areas kind of end up losing laxity and losing collagen, so it's nice to be able to utilize these in different areas to help kind of replenish that. Mm-hmm.
Dr. Zain Husain, MD: [00:14:15] Yeah. And along the vein, I mean, we're talking about. Inducing collagen synthesis. Mm-hmm. Um, I know some people feel a little funny about, you know, injecting something foreign into your body.
Um, you know, they're really looking for, for a [00:14:30] natural regenerative technique. Um, so PRP, platelet rich plasma is another option we're using our own body's growth factors to. Um, stimulate collagen synthesis. So what we do in the office, we actually draw your blood. We take that tube of blood, we spin it in a centrifuge, [00:14:45] separate it, there's a layer of your blood, which contains growth factors.
We extract that and we actually inject it. And over time it can help to, um, you know, build collagen. Um, also helps with wound healing and inflammation, um, and gives you a nice glow. It's [00:15:00] definitely a lot more subtle than these, um, these fillers, but it is an option that we can offer to our patients that, you know, especially for those who are just a little.
Iffy about putting something foreign to their body. I think that is a nice option.
Heather Murray, PA-C: Yeah. The nice thing [00:15:15] about these Biostimulatory products is patients will always say they feel like Benjamin Button. They feel like they're aging backwards. Mm-hmm. And so they definitely have a place to age gracefully.
Mm-hmm. And most people. Don't know that you had something [00:15:30] done. Mm-hmm. You just look kind of rejuvenated. Yeah. Um, and just slightly volumized,
Dr. Zain Husain, MD: I also have those patients who don't want a blood draw. Yeah. Or get a little freaked out about like, putting blood on their, on their skin or injecting it. Um, so [00:15:45] there are also exosomes.
Mm-hmm. Um, you know, that are. Really making a big splash in the regenerative and aesthetic markets. Um, it's not FDA approved for injection, but topical application, um, has been used and we're seeing some promising [00:16:00] results. So I'm looking to, I'm looking forward to seeing like the studies and you know, what they will show, um, for the future.
Courtney Carroll, LE: Lasers and energy based devices we can kinda hit on next. Um, so we use a lot of different [00:16:15] devices in our office. We call them our toys.
Dr. Zain Husain, MD: My favorite toys. Yeah.
Courtney Carroll, LE: So, um, I guess we'll probably start with non-ablative fractional lasers, which we do a lot of. So
Dr. Zain Husain, MD: there's two flavors of fractional lasers that we [00:16:30] use for helping to induce collagen synthesis.
So non-ablative fractional technologies use wavelengths of light that penetrate into the dermis, create micro injury, a wound response, um, and stimulates, you [00:16:45] know, the skin to produce more collagen and rejuvenate. Whereas a blade of fractional lasers use light energy to target water on the surface of the skin and kind of creates these little micro channels of injury and also ablating [00:17:00] portions of that to stimulate, um, tightening.
But you know, mainly to improve surface irregularities such as pigment tone, um, tightening, all those things can really help. Um, the skin. So those are those [00:17:15] fractional lasers and although they don't really restore volume like we alluded to earlier, they do help with collagen production, skin quality. It can help enhance and be a nice adjunct to these other volumizing, um, you know, procedures that we do in the office.
So, you know, the skin is [00:17:30] all kind of interconnected and, you know, improving the skin quality at the surface also can make a big impact, um, along with the volumization to give you a really nice natural aesthetic. In addition to, um, you know, the non-ablative fractional lasers, um, we also [00:17:45] have microneedling technologies.
So you wanna talk about that?
Courtney Carroll, LE: Yeah. Yeah. And I absolutely love the radio frequency microneedling. We've had so many patients now where we've treated their abdomen especially. Um, you know, women post [00:18:00] pregnancy who have like these stretch marks or just that sagging skin. It's, you know, I, I think a lot of women don't talk about it really, but it's time and time again, we're seeing it, it's such a common problem and mm-hmm.
Um, the RF microneedling really [00:18:15] shown fantastic results on just tightening that skin. So, you know, when you think about weight loss and how that connects too, I mean. You can treat the arms, you know, that that kind of saggy skin that's resulted from that weight loss, the, the abdomen, you [00:18:30] know, stretch marks mm-hmm.
Where, um, you know, once you've lost the weight, those remain. So we're see thighs, the inner thighs, we had a patient, we treated her inner thighs and they look amazing. So all different areas that, um, people don't really think of mm-hmm. That the, the [00:18:45] RF microneedling is really tackling, um, just by tightening those areas.
Mm-hmm. And, and. You know, helping out, showing nice results.
Dr. Zain Husain, MD: Yeah. And what about like, like, you know, like the jowls and like the, the neck? Mm-hmm. We've seen some really impressive results and at the right depths you can get some [00:19:00] really nice tightening. And I know that at the. Wrong depth, you can actually get that paradoxical fat loss, which we really wanna avoid.
Yeah. So that's why it's really important to see someone who has that expertise, because we're seeing all those patients who've gotten like this weird, like fat loss and [00:19:15] laxity from, you know, procedures with the Morphe aps. And so that, that's a big thing right now. Um, so you can use those technologies, um, in a safe and effective manner, but you really need to understand the science behind it.
Courtney Carroll, LE: Yeah, [00:19:30] there's definitely certain depths that you don't really wanna mm-hmm. Go past and especially in areas like, you know, the cheeks where you're not trying to dissolve that fat. Um, you wanna sustain it, but, you know, along the jawline, definitely. Um, the tightening effect that we've seen is, is really nice and I think that's where a lot of [00:19:45] people tend to Yeah.
Um, want to see their results who have lost that weight because of that sagging skin mm-hmm. In the jowl. So just kind of tightening that area up. Mm-hmm. Um, and then, you know, of course the improvement on overall skin texture, appearance of pores [00:20:00] wrinkles, fine lines, it's all a nice benefit.
Dr. Zain Husain, MD: Yeah. And the highly focused ultrasound, um, you know, other technologies too can help tighten the skin and just kind of give that nice appearance.
Um, you know, that skin tightening. Um, in addition to that, volumization. Um, with other [00:20:15] procedures. Yeah. Um, but honestly, I tell my patients, um, I have a lot of tools in my tool belt and I like using a lot of them in combination.
Heather Murray, PA-C: Yeah. You can customize the treatment plan and
Dr. Zain Husain, MD: it really makes a big difference.
So I'm using my, you know, my fillers for [00:20:30] structure and volumization. Bio stimulation to help with collagen synthesis. I'm using my energy based device and lasers to kind of resurface and kind of improve and they all kinda work synergistically to get you really cohesive, aesthetic result. And that's kind [00:20:45] of what patients want a natural aesthetic.
Um, it's not a one size fit all. Um, it's very customized and it's a journey. It's not gonna happen overnight. Mm-hmm. So we have patients who are with us for months, you know, kind of working on this. And [00:21:00] with the right treatments and the right sequence, we can see some beautiful results.
Courtney Carroll, LE: Yeah. I mean, even, um, you know, one of our coworkers, we've seen her journey and it's just been really amazing to watch mm-hmm.
The kind of before and after. Um, one day we'll get her on here. [00:21:15] Yes. We'll, and dry her on. But, you know, and to speak to that, just different, um, procedures and mm-hmm. I think it's been a nice journey because it's not it, it's been. A slow lead up to that. Mm-hmm. We're not just throwing everything on.
[00:21:30] Exactly. Yeah. Um, it's, you know, you don't wanna rush these things. And I think, um, being careful and being safe are obviously top priorities, but then, you know, getting those results is, second priority. And it's been amazing to watch her journey, um, [00:21:45] through,
Heather Murray, PA-C: yeah. Dr. Zane, I think you found a, a really good article about a patient who had a combo of treatments in her before and afters on the screen here.
Yeah, this
Dr. Zain Husain, MD: actually came out very recently. Um, this woman, I. Was treated [00:22:00] with, um, Restylane products. I think specifically Restylane Lift and Contour, as well as s Sculptra. And as you can see, she has Volumization. , she had been on Ozempic, , that's her before photo. With the Volumization [00:22:15] and then the bio stimulation with s Sculptra, you can see a beautiful natural result.
She looks rejuvenated. And yeah, I mean that's the kind of result that we're looking for to help these patients feel their best, feel confident in their skin.
Courtney Carroll, LE: I like that. Like on this [00:22:30] picture too, you can see like in the first picture, her, her smile, you know, just normal. But she's just got that little curve, upward curve and it's just, you could, you can just tell she probably is so ecstatic.
Yeah. You know, it's like a nice little. Little tidbit in there. Yeah.
Dr. Zain Husain, MD: And her [00:22:45] skin's glowing. Yeah. It looks really, really good. Natural. And, um, I'm sure she's thrilled. I mean, look at that jawline. Yeah,
Courtney Carroll, LE: yeah, yeah. The jawline alone and then just even, the pigment it looks like, which, you know, sometimes that I think tends to age us to sun damage, [00:23:00] um, over, over a lifespan that we accumulate.
Heather Murray, PA-C: Yeah. I think it's important too, to con. Combo these treatments with, you know, skincare at home, making sure you've got absolutely great skincare, hydration, um, making sure you're wearing [00:23:15] sunscreen every day, and that can help keep your results maintained.
I always, um, tell my patients, you know, you go to the dentist twice a year.
So in between those trips, what are you doing at home? You're brushing your teeth, you're [00:23:30] flossing. So it's the same thing with skincare. I mean, you can do all these procedures, but if you're not doing the home's, the at home care, it's, you know, a little negligent. You're spending all of this money, you wanna make sure that you're mm-hmm.
Keeping this investment worthwhile. Yeah.
Dr. Zain Husain, MD: Yeah, [00:23:45] absolutely. I think this has been a great discussion on the phenomenon known as Ozempic face, um, but just the skin changes that we're seeing with these GLP one agonists, and I do think that. Patients who are on [00:24:00] this need to know that there are options.
Yeah. Um, if they're loving the results that they're seeing in their body, but they're not feeling great about how their face is looking, there are ways for us to help them, um, and safe, effective tools, um, that we can provide for them.
Courtney Carroll, LE: You're [00:24:15] not alone. Other people deal with this you know, skin sagging. The, the volume loss, it's. Very common. Um, so there are definitely, multiple treatments that you can do for this, but you really do wanna see someone who knows what they're doing and is ex [00:24:30] experienced like Dr. Zane, just because.
The cost that you will spend fixing that problem is a lot more than what you would probably spend in the first place.
Heather Murray, PA-C: Yeah. And we're always here to help guide you and ensure that you're getting the most effective treatments to [00:24:45] help you meet your goals.
Dr. Zain Husain, MD: Yeah. So thanks for joining us on our latest episode of Skin Side Out where we talk about all things skin, health and beauty.
You know, this was a really enlightening, um, you know, discussion. And if you have any questions, let us know, [00:25:00] but don't forget to like, subscribe and follow us skin side out.