[Rapid weight loss through GLP-1 receptor agonists as lifestyle phenomenon and implications for plastic esthetic medicine].

BACKGROUND: Glucagon-like peptide‑1 receptor agonists (GLP‑1 RA), such as semaglutide and tirzepatide were originally developed for treatment of type 2 diabetes and have shown significant weight loss effects. This has led to increasing off-label use for esthetic weight reduction. The associated facial changes, particularly volume loss, skin laxity and increased wrinkle formation, are gaining attention in plastic esthetic medicine. OBJECTIVE: This study reviews the current literature on GLP‑1 RAs, their esthetic effects and potential therapeutic approaches. METHODS: A selective literature review on GLP‑1 RAs was conducted, focusing on mechanisms of action, clinical effects, off-label use, esthetic consequences and treatment options. RESULTS: The use of GLP‑1 RAs promotes weight loss by regulating appetite and delaying gastric emptying. Frequent side effects include gastrointestinal symptoms, such as nausea, vomiting, diarrhea or obstipation. A possible association with thyroid tumors remains unclear. The increasing off-label use has led to supply shortages in some regions. Esthetic changes, termed "Ozempic face", include volume loss, skin laxity and pronounced wrinkles. Treatment options discussed in the literature include noninvasive (high-intensity focused ultrasound, HIFU, radiofrequency), minimally invasive (fillers, biostimulators) and surgical procedures (facelifting, fat grafting). CONCLUSION: The rising off-label use of GLP‑1 RAs presents new challenges for esthetic medicine. Rapid fat loss results in pronounced facial changes, driving demand for corrective interventions; however, systematic studies on the effectiveness and safety of this treatment are lacking. Further research is needed to develop evidence-based strategies and standardized guidelines for the esthetic management of affected patients.