A national survey shows how GLP-1–associated weight loss is driving facial volume loss, laxity, and wrinkles—and why fillers and neuromodulators anchor treatment for this growing patient group. Plastic Surgery Practice talks to one of the study’s authors to break down the findings and what they mean for treatment planning in today’s aesthetic practice.
The rapid adoption of glucagon-like peptide-1 (GLP-1) receptor agonists for medical weight loss is reshaping not only metabolic health, but also the aesthetic profiles of a growing patient population. As facial fat volume diminishes alongside overall weight reduction, many patients present with new or accelerated concerns—most notably midface volume loss, skin laxity, and deepening wrinkles or folds—driving increased demand for non-surgical facial rejuvenation and multimodal treatment strategies. A large, national survey of U.S. aesthetic healthcare providers explores how these changes are manifesting in clinical practice and which treatment approaches are emerging as standards of care.
In this interview with Plastic Surgery Practice, Joely Kaufman, MD, a board-certified dermatologist, fellow of the American Academy of Dermatology, and director of Skin Associates of South Florida in Coral Gables, discusses findings from the study, Survey of Facial Aesthetic Concerns and Treatment Trends Following GLP-1 Agonist-Associated Weight Loss, presented at the 2025 American Society for Dermatologic Surgery Annual Meeting, and shares how plastic surgeons and other aesthetic providers are adapting their treatment algorithms to address the unique facial changes associated with GLP-1–related weight loss.
Plastic Surgery Practice: What motivated you to investigate facial aesthetic changes specifically associated with GLP-1 agonist–related weight loss?
Joely Kaufman, MD: Our motivation stemmed from the rapid and significant increase in patients using GLP-1 agonists; HCPs in our survey (including plastic surgeons and dermatologists as well as others with experience in cosmetic procedures) reported that the number of patients receiving these medications more than doubled—a 137% rise from 2023 to 2024. This substantial weight loss that results from GLP-1 use can be beneficial for overall health, but often leads to specific and challenging facial aesthetic concerns such as reduced fat volume, skin laxity, and the emergence of wrinkles and a gaunt appearance. We recognized a critical need to understand these emerging concerns and the current treatment strategies employed by aesthetic providers to better support both patients and clinicians in this growing area.
PSP: Based on your survey findings, which facial areas do healthcare providers report as being most affected by GLP-1–induced weight loss?
Kaufman: According to the healthcare providers surveyed, the areas of the face and neck deemed most impacted by GLP-1–induced weight loss were midface volume loss, skin laxity, and wrinkles/folds. These changes often combine to create an aged or gaunt appearance that patients often seek to address, presenting unique challenges in aesthetic restoration.
PSP: Providers noted a significant increase in GLP-1 patients from 2023 to 2024. How do you interpret this surge and its impact on aesthetic practice trends?
Kaufman: This surge, where GLP-1 patient numbers more than doubled from 2023 to 2024, signifies a profound and rapidly evolving shift in the aesthetic market. We interpret this as a significant “growing tailwind” for aesthetics, creating a large patient population with new and multiple aesthetic concerns. Many of these patients are new to the aesthetics market. This trend is so impactful that medical weight loss has become the second-largest source of revenue for aesthetic practices, driving a clear increase in demand for both non-surgical facial treatments and body contouring procedures.
PSP: Your study highlights hyaluronic acid fillers and botulinum neurotoxins as the primary treatments used. What factors make these modalities the leading choice for GLP-1 patients?
Kaufman: Hyaluronic acid (HA) dermal fillers (used by 81% of HCPs) and botulinum neurotoxins (used by 69%) are leading choices because they directly address the core aesthetic changes associated with GLP-1 weight loss. The weight loss predominantly causes midface volume loss, which HA fillers are ideally suited to replenish, restoring a more youthful contour (notably, HA was considered the best option for 47% of patients). Neurotoxins, on the other hand, effectively treat the wrinkles and folds that become more prominent with underlying volume loss and skin laxity. Together, these injectables offer precise, non-surgical solutions for the key concerns, often forming the foundation of a multimodal treatment plan.
PSP: Nearly half of GLP-1 patients receive multimodal treatment. What does this tell us about the complexity of restoring facial balance after medication-related weight loss?
Kaufman: The fact that nearly half of GLP-1 patients (49%) receive multimodal care—which may include injectables, energy-based devices, and topical skincare—underscores the inherent complexity of restoring facial balance after medication-related weight loss. The aesthetic changes, involving volume loss, skin laxity, and wrinkles simultaneously, are multifaceted. No single treatment can fully address all these concerns comprehensively. This indicates that a personalized, multimodal approach is often necessary to achieve optimal and natural-looking outcomes, reflecting the diverse and interconnected nature of the aesthetic challenges presented by these patients.
PSP: You found that hyaluronic acid fillers are typically used before botulinum neurotoxins. Can you explain why this sequence is the most commonly preferred treatment protocol?
Kaufman: The most frequently reported treatment sequence is hyaluronic acid fillers followed by botulinum neurotoxins for a logical clinical reason. GLP-1-induced weight loss’s most impactful facial change is often volume loss, particularly in the midface. HA fillers directly address this foundational issue by replenishing lost volume and providing structural support, which can help to lift and improve overall facial contours. Once this underlying volume is restored, neurotoxins can then be more effectively and strategically used to fine-tune dynamic wrinkles and folds, as the skin and facial structure are already better supported. This sequence allows for building a stable and harmonious foundation first before addressing more superficial dynamic concerns. PSP
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