Hyperdilute Radiesse Preserves Facial Volume in Glucagon-Like Peptide-1 Receptor Agonist Users Undergoing Rapid Weight Loss

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Abstract Biostimulators like hyperdiluted calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC; Radiesse, Merz North America, Franksville, WI) are effective in promoting neocollagenesis and restoring facial volume. The emergence of glucagon-like peptide-1 (GLP-1) receptor agonists (GLP1RAs) for weight loss has introduced a subset of patients experiencing rapid weight loss with associated facial-volume changes, colloquially known as “Ozempic Face” (Novo Nordisk, Bagsvaerd, Denmark). This case series describes 4 patients on GLP1RAs who, despite rapid weight loss, maintained facial volume following treatment with hypderilute CaHA-CMC in the lower face. Four patients undergoing rapid weight loss with GLP1RA were retrospectively evaluated following hyperdilute (1:3) CaHA-CMC treatment in the lower face. Patient demographics, BMI, average weight loss, and follow-up assessments were reviewed. Responses were evaluated using standardized photographs, the Global Aesthetic Improvement Scale (GAIS), and patient satisfaction surveys. All 4 GLP1RA users completed both treatment sessions and 6 months follow-up. They lost an average of 24.3 ± 10.4 lb, equivalent to −9.2 ± 4.8% of baseline body weight, yet objective facial metrics remained stable or improved. Average cheek volume increased 9.8%, jowl volume declined 55.8%, nasolabial-fold depth decreased 46.2%, and marionette-line depth decreased 20.6%. At 6 months, investigator GAIS rated every patient “improved” or “much improved,” and 100% of patients reported being “satisfied” or “very satisfied.” Hyperdilute CaHA-CMC may offer benefits in preserving facial volume for patients undergoing weight loss with GLP-1 agonists. Further studies are warranted to elucidate the mechanisms and optimize treatment protocols for this population. Level of Evidence: 4 (Therapeutic)

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