In a continuing conversation, Joely Kaufman, MD, discussed how clinicians can better manage expectations and treatment planning for the growing number of aesthetic patients using GLP-1 medications. Early on, she noted, many patients did not disclose that they were taking GLP-1 drugs for weight loss, leading to surprises in clinical outcomes. In response, her practice added direct questions about current or planned GLP-1 use to their intake forms. Kaufman emphasizes that dermatologists should accompany patients throughout their weight-loss journey rather than waiting until weight stabilizes. Because even a modest loss of 10 pounds can alter facial contours, she advises initiating conversations proactively to help patients understand predictable changes and to intervene early.
She highlighted that early management may be simple: improving skincare routines, reinforcing sunscreen use, or adding retinoids or glycolic acids. As changes progress, providers can layer in injectables, hyaluronic acid fillers, botulinum toxins, biostimulatory agents, and devices. Addressing concerns immediately empowers patients, prevents surprises, and helps clinicians guide them through aesthetic adjustments more smoothly.
“I think talking about it upfront is even more important than catching it on the backside because some of these things are preventable,” Kaufman noted.
Kaufman then outlined key gaps that remain in the field. GLP-1 medications have only been widely used outside the diabetic population for about 5 years, so dermatologists are still learning alongside their patients. She distinguished GLP-1 weight loss from the rapid, substantial loss seen with gastric bypass, noting that GLP-1 patients lose weight more gradually and may experience different patterns of facial fat change. Importantly, GLP-1 receptors are present in dermal white adipose tissue, suggesting that aesthetic changes may stem not only from overall fat reduction but also from direct effects on facial fat metabolism. This raises new clinical questions about long-term facial aging patterns that require further study. She underscored that mid-face volume loss consistently emerges as the most significant concern, reinforcing the need for a multimodal, holistic approach combining skincare, devices, microneedling, fillers, and neuromodulators.
Kaufman concluded with a clear takeaway for clinicians: start early. Even minimal early mid-face support can help prevent more dramatic aging changes as patients continue GLP-1 therapy. As GLP-1 use expands for diverse health conditions, dermatologists should prepare for ongoing growth in this patient population and incorporate proactive screening and counseling into their workflows.