When a patient loses 200 pounds, the transformation is extraordinary by any measure. But GLP-1 medications like Ozempic (semaglutide) drive fat loss that isn’t selective. As the body sheds mass, the fat pads responsible for facial structure and softness diminish too, leaving some patients with hollowed temples and sunken cheeks that feel at odds with an otherwise dramatic result.
That’s the situation one patient brought to Dr. Sheena Kong, a board-certified Internal Medicine physician and Harvard-trained specialist practicing in San Francisco. Referred by a fitness professional, the patient came to her with a specific concern: despite a remarkable weight loss, his face had changed in ways he wasn’t prepared for. What followed was a staged treatment plan rooted in a principle central to her practice: that lasting results depend on getting the sequence right.
What GLP-1 Weight Loss Can Do to the Face
Significant weight loss affects the face in ways many patients don’t anticipate. The fat pads that fill the midface and temples diminish alongside body fat, and when that loss is substantial, the face can take on a hollow or skeletal quality. Cumulative sun exposure compounds the problem, as UV damage degrades collagen and elastin even as facial fat continues to decline.
For this patient, Dr. Kong described the presentation as notably hollow and skeletal, compounded by sun damage that had reduced skin elasticity over time. A multi-stage approach was needed to address the full picture. The key factors shaping the treatment plan included:
- Significant facial fat loss across multiple areas of the face
- Diminished skin elasticity from years of sun exposure
- Reduced collagen and elastin throughout the skin
Stage One: Immediate Contour with Hyaluronic Acid Filler
Dr. Kong’s first clinical step was restoring facial contour with hyaluronic acid dermal filler. Getting a visible result early was deliberate. A patient who has already been through a significant health transformation needs to see that aesthetic improvements are actually working, and establishing visible contour up front prepared the face for what Sculptra would later build.
After injection, Sculptra produces an initial volume boost from the injected solution. That boost fades within days, well before the collagen-building response has time to develop. A patient who doesn’t understand that timeline can feel discouraged before results actually arrive. By addressing contour with hyaluronic acid filler first, Dr. Kong established a clear result and set realistic expectations for the stages ahead.
Stage Two: Building Long-Term Volume with Sculptra
With a foundational contour in place, Sculptra became the longer-term strategy. This collagen-stimulating injectable builds volume progressively over multiple sessions, as the body produces new collagen. For a patient with this degree of volume loss, a progressive, collagen-led approach tends to produce the most natural-looking result.
A 2026 study published in the Aesthetic Surgery Journal supports this combined approach. Researchers followed 41 GLP-1 patients who had lost a mean of 34 lbs and treated them with Sculptra and Restylane Lyft or Contour over nine months. Measurable skin quality improvements were seen across all tracked parameters, and 88% of participants reported improved facial appearance at the nine-month mark, with 91% saying they would recommend the regimen to others.
Depending on how the patient progresses, Ultherapy for deeper skin tightening or Fraxel Dual laser for sun damage and texture can be added to the plan. Dr. Kong evaluates these individually, based on what each patient’s skin actually requires.
Thinking Beyond the Face
GLP-1 weight loss raises considerations that extend well beyond the face. Dr. Kong coaches these patients on muscle preservation, with guidance that may include:
Adequate dietary protein intake to help maintain muscle mass
Regular exercise as a foundation for body composition
Working with a personal trainer when appropriate
For localized fat that GLP-1 medication may not fully address, Dr. Kong may consider options such as CoolSculpting Elite or Smartlipo Triplex. Every decision is guided by the individual patient’s anatomy and goals.
A Personalized Path Forward with Dr. Sheena Kong, MD
This case illustrates that significant weight loss can change the face in unexpected ways, and that restoring it well takes more than a single treatment. Dr. Kong’s approach reflects how she evaluates every patient: with staged planning and a clear rationale behind each decision. To explore a plan tailored to your situation, schedule a consultation at Dr. Sheena Kong MedSpa today.
This information is provided for educational purposes only and does not replace a consultation with a board-certified physician. Outcomes, risks, and suitability vary from patient to patient.
