From the corner office
Recently, I have been seeing more and more patients who have lost a significant amount of weight with the help of new Semaglutide/GLP-1 medications (the most commonly-used ones are Wegovy and Ozempic) and are now dealing with some unintended consequences of acute weight-loss. These patients love their new, lighter, more comfortable bodies but are unhappy with how it makes their faces look drawn, gaunt, tired, older and unhealthy.
I thought that it would be informative if I explain in some depth the new class of weight loss medications and then review how current facial treatments are well-suited to address the aesthetic downsides of rapid, dramatic weight loss.
The most recent complete data (NHANES, 2017-2018) on US adults who are overweight (30.7%), obese (42.4%) or severely obese (9.2%) as well as the dramatic rise in associated type 2 diabetes (10.8%), speaks to the need for new approaches to weight management and explains the excitement and potential positive health impacts of a new class of medications designed to treat these conditions.
Glucagon-like peptide-1 (GLP-1, aka Semaglutide) is all the rage these days. GLP-1 promotes insulin secretion and regulates replenishment of insulin stores in pancreatic beta cells, which lowers circulating blood sugar. It promotes a feeling of satiety by binding to cells in the brain stem and hypothalmus, and slows gastric emptying which promotes a feeling of fullness while eating.
Two well-advertised GLP-1 medications include Ozempic, which was developed as a treatment for type 2 diabetes and Wagovey, which is the same medication marketed as a novel and effective weight-loss medication. These two medications are delivered via a once-per-week, self-administered injection. After one year, adults taking Wegovy lost 15% of their body weight (35 lbs.) on average, compared to a 2.5% weight loss (6 lbs.) in those taking a placebo. To highlight just how popular these medications have become, Novo Nordisk, the Danish pharmaceutical manufacturer, accounts for 2% of the Danish gross domestic product (GDP) due to the sale of these two medications!
A newer medication, Mounjaro (Tirzepatide), made by Eli Lilly, is the first diabetes medication to target both hormones that regulate blood sugar levels: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). This
medication has been shown to be even more effective than GLP-1 alone in improving type 2 diabetes and promoting weight loss. Zepbound is the brand name of the same medication targeted towards weight-loss. Both of these are also injected weekly.
Lastly, Rybelsus, also manufactured by Novo Nordisk, is a once-per-day oral GLP-1 receptor agonist that has been shown to be equally effective to the injectable Semaglutides.
Needless to say, the race is on to develop ever more effective and easier to administer medications in this category with the understanding that they need to be taken for one’s lifetime or risk worsening type 2 diabetes and/or putting back the weight that was lost.
To combat the often dramatic and acute weight loss induced facial de-volumization that accompanies the use of GLP-1 +/- GIP medications, injectable hyaluronic acid (HA) fillers seem tailor-made. They effectively replace the lost facial volume that occurs due to dramatic fat loss, allow for precise to the millimeter artistic control, often last for years when injected deeply on bone, and are unaffected by weight gain or loss. For those who follow our practice, you are well aware of the Injecta-Lift technique I developed to three-dimensionally replenish lost facial volume and restructure the face, making it appear more balanced, youthful and beautiful. The only difference in patients with significant, acute facial volume loss is the increased amount of filler needed to address the problem.
To correct sagging neck skin the treatment options range from minimally invasive Profound RF to surgical procedures, including a direct neck lift or a lower face and neck lift, depending on the degree of sagging, the patient’s age, skin type, aesthetic goals and many other mitigating factors.
Thanks to medical science and techniques at my disposal, you can maintain a healthy and flattering body weight while having a beautiful or handsome appearance that makes you smile when you look in the mirror.
Eat healthy, get fit, look great!
Seth A. Yellin, MD, FACS
Founder & Director, Marietta Facial Plastic Surgery, Laser & Aesthetics Center
Fellow, American Academy of Facial Plastic & Reconstructive Surgery
Diplomate, American Board of Facial Plastic & Reconstructive Surgery
Fellow, American Academy of Otolaryngology-Head & Neck Surgery
Diplomate, American Board of Otolaryngology
From The West Cobb Office
April is all about the glow at Marietta facial plastics, laser and aesthetics center! Our aestheticians are hard at work getting your skin as glowy as possible for spring with diamond glows, dermaplaning and the illuminize peel! It’s also a great time to get a Skinvive treatment. I will be repeating my Skinvive treatment after 6 months and I am so excited to do so! I can say first hand that it is an injectable that will leave your skin looking amazing.
Skinvive is an injectable that hydrates your skin. It is not adding volume but working on a cellular level to leave your skin looking dewy and fresh for up to 6 months. So if you struggle with dry skin, post inflammatory pigmentation, and even fine lines- Skinvive may be a great treatment option for you. You can also use those Alle points towards a Skinvive treatment.
I hope you’re enjoying the beautiful weather and I look forward to seeing your beautiful faces this month!
Kelly A. Houmand, MMS, PA-C
770-425-7575
Marietta Facial Plastic Surgery, Laser & Aesthetics Center
Marietta – West Cobb