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Late-Breaking Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Late-Breaking Scientific Orals: Facial Plastic and Reconstructive Surgery and Pediatric Otolaryngology

Radiographic Mid-Facial Volume Changes in Patients on Glucagon-Like Peptide-1 Agonists

Monday, September 30, 2024
8:54 AM – 9:00 AM EDT
Location: MBCC, 222
Disclosure(s):
Sahar Takkouche, MD, MBA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Surgeons report an increase in patient concerns regarding “Ozempic Face” — a reported side effect of GLP-1 agonists that results in facial deflation and a prematurely aged appearance. No objective data exists to quantitatively characterize midface volume loss in these patients. This study intends to characterize this phenomenon using radiographic imaging of patients using this class of medications for weight loss.

Methods: Hospital-level EMR data was systematically queried for patients with GLP-1 agonist prescriptions, and head & neck imaging (CT/MR) both before and after prescriptions between 2017-2024. Only patients with adequate imaging within 5 years of prescriptions were included. Mid-face volume was manually measured for patients on available scans. Changes in total, superficial, and deep midface volume were measured. Spearman correlation and linear regression were conducted to understand the relationship between weight loss magnitude and facial volume changes.

Results: In total, 20 patients with available imaging were included for analysis. The median age of patients was 54 years old (IQR 48-61). The average duration of GLP-1 agonists was 321 days (SD = 291) and the average weight loss was 11 kg (SD = 6.9). The median percent decrease in total midfacial volume was 9% (IQR 3%-14%). Superficial volume decreased by 11% (IQR 5-15%) and deep volume decreased by 7.0% (IQR -20-15%). Spearman correlation showed a relationship between weight loss and superficial volume loss (rho = 0.59, p = 0.006) but not deep volume loss (r = 0.115, p = 0.629). Linear regression showed a loss of 7% facial volume for every 10kg of weight lost (r = 0.063, SE = 0.003, p = 0.0293).

Conclusions: Patients can expect an average loss of 7% of midfacial volume for every 10 kg of total weight loss, primarily in superficial fat pads. This information can inform patient counseling regarding GLP-1 agonist effects and impact clinical decisions for surgeons who may consider procedures such as buccal fat transfers in these patients. This represents the first quantitative assessment of facial changes during GLP-1 agonist use.

    Presenting Author(s)

  • Rahul Kamal Sharma, MD

    Resident Physician
    Vanderbilt University Medical Ctr
    Nashville, Tennessee, United States

    Disclosure information not submitted.

    • Co-Author(s)

  • Kelly L. Vittetoe, MD

    Resident MD
    Vanderbilt University
    Nashville, Tennessee, United States

    Disclosure information not submitted.

  • Sahar Takkouche, MD, MBA

    Assistant Professor
    Vanderbilt University Medical Center
    Nashville, TN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • SY

    Shiayin F. Yang, MD

    Assistant Professor
    Vanderbilt University Medical Center, United States

    Disclosure information not submitted.

  • SS

    Scott J. Stephan, MD

    Associate Professor
    Vanderbilt University Medical Center
    Nashville, TN, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Priyesh N. Patel, MD

    Assistant Professor; Residency Program Director
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

    Disclosure information not submitted.