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My first real encounter with ‘Ozempic face’ was painfully direct. It arrived in the form of a photograph a friend sent me on WhatsApp after a party we had both attended.
In the picture, I was beaming, slimmer than I had been for years. But then I looked more closely. What on earth had happened to my face?
Beneath my eyes were two bizarre, sausage-like swellings. My neck was not faring much better either, appearing loose, creased and worryingly saggy.
Actress Catherine Deneuve once observed that a woman eventually has to choose between her face and her backside.
But I had no desire to make that choice. Like thousands of women around the country, I had noticed my expanding middle-aged waistline and taken action. I had started weight-loss injections. The downside was that my face appeared to have paid the price.
That is why reports earlier this month about a new treatment caught my attention. Croda, the 100-year-old British chemicals company, has repurposed a long-established skin-plumping compound to target the looseness associated with Ozempic face.
The ingredient, Volufiline, is derived from the root of the Chinese plant anemarrhena. It was once included in body creams, although sales were modest. Interest has surged after claims that it may help counter the hollow, gaunt appearance that can follow rapid weight loss.
TikTok has declared Volufiline an ‘it’ ingredient, while skincare brand The Ordinary introduced the first High Street serum containing it this year. French and Korean beauty companies are now racing to develop their own formulas, and Croda’s previously depressed share price has climbed sharply.
I only wish I had heard about it in 2023, when I was first prescribed Ozempic.
It was not a decision I made casually. By April that year, weighing just over 11st, I felt increasingly unwell. I had reached almost a size 14 after years of being a size 10, and at 48 I was dealing with perimenopause and persistent bloating.
Like thousands of women around the country, I noticed my growing middle-aged spread and turned to weight-loss injections. The consequence, however, was a dramatic change in my face, writes Olivia Falcon
Left: Olivia in October 2023, around five months after starting Ozempic and losing weight. Right: Her face following recent Xerf, Profhilo Structura and SkinVive hydrating treatments
My main worry was not how I looked but what the weight was doing to my health. I was suffering from severe lower-back pain, while blood tests showed prediabetes and high cholesterol: my level was 6.6, compared with NHS guidance that it should be below 5. I had two daughters, then 11 and 12, to keep up with, and I did not want to enter middle age feeling as though I had the energy of an old person.
The extra weight had also eroded my confidence. Fashion has always been important to me; I spent four years at Vogue as assistant to then-editor Alexandra Shulman before becoming beauty editor at Tatler.
Appearing fit and well has long been part of my professional life. Yet instead of reaching for my favourite structured Roland Mouret dresses and tailored trousers, I had retreated into loose Zara dresses. I wanted to recognise myself again.
For six months, I held off taking weight-loss injections and tried everything from supplements and extra exercise to working with a nutritionist. But any weight I lost by avoiding pasta and pushing myself to exercise returned as soon as my discipline wavered.
Eventually, I arranged a medical consultation with private doctor Wendy Denning at the Health Doctors practice on Devonshire Place in central London. Following a thorough assessment, including blood tests, a thyroid examination, BMI measurement and a detailed medical history, she prescribed Ozempic.
Weight-loss injections were still relatively new at the time, and I knew only a few people who were using them. I was certainly nervous. I am the kind of person who would rather tolerate a headache than take a paracetamol. Still, I trusted Wendy and started on 0.25mg before increasing to 0.5mg after four months.
Taking the medication gradually meant I avoided the usual nausea and constipation, while losing the stubborn 7kg — slightly more than a stone — over six months.
I also saw significant changes in my face. Despite my burgeoning midlife weight gain, I’ve always had quite a long, thin face and I suspect the changes showed up sooner on me than they would on more round-faced women.
There wasn’t much spare fat to lose, and it didn’t take long for definition to tip into depletion. Dermatologist Dr Lindsey Bordone puts it plainly: ‘Anyone who loses weight quickly notices changes in their face.’
Loss of fullness can leave skin looking looser and lines more apparent. Midlife skin is also part of ageing, of course – the medication isn’t necessarily responsible for every change, but it definitely doesn’t help.
I was confident that my face wasn’t sagging enough to merit surgery, but my under-eye problem needed a full examination.
About a week after sausage-gate, I saw Dr Munir Somji at his Dr MediSpa clinic in Knightsbridge. He examined the area with a handheld ultrasound device and identified the problem.
With weight loss, the fat pads under my eyes had diminished, which then allowed old under-eye filler – which I’d had injected five years before – to shift and migrate down my face.
In fact, it’s a well-documented phenomenon: when facial fat shrinks away, you remove the cushioning and camouflage around facial filler and get weird, conspicuous rolls and bumps.
For me, Ozempic and now Mounjaro has been genuinely life-enhancing and improved my health. But I’ve also learnt that losing weight comes with compromises
Dr Somji’s solution was to dissolve them using hyaluronidase, an enzyme that breaks down the hyaluronic acid in filler. I noticed an immediate improvement as the sausages flattened.
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But then there was my neck. The neck is often described as ground zero for ageing because the skin is thinner than in many other areas of the face, and I was a textbook example of Ozempic-induced scrawniness.
As the founder of The Editor’s List, a cosmetic concierge service that directs my clients to the best cosmetic doctors and surgeons in the world, I’m lucky to be able to access expert advice.
It was the brilliant Dr Paris Acharya, who has a light hand and a very good eye, who told me about an injectable treatment known as a Radiesse wash. Radiesse is a gel filler containing tiny calcium hydroxylapatite particles – a mineral found in bone and often used in dentistry.
Used in a highly diluted form and distributed beneath the skin with a cannula, it’s intended to stimulate collagen and improve skin quality rather than simply deliver bulk. I like to think of it as encouraging the creation of fresh scaffolding beneath thinning skin.
I felt I could see a difference after one treatment (which was fortunate considering that it costs about £500 a session), although collagen rebuilding takes at least six weeks.
Treatment courses and longevity vary – two sessions about six weeks apart are often recommended, with benefits lasting roughly 18 months.
I had my treatment about 14 months ago and have been very happy with the result, although recently the crepiness has started to return. To maintain my results and keep my neck looking less straggly, I recently tried the treatment XERF – beloved of Kim Kardashian – with Dr Nyla Raja at her clinic in Mayfair, west London.
This radiofrequency device, which arrived in UK clinics last month, works by delivering controlled heat beneath the skin. The claim is that it encourages collagen remodelling and improves firmness, which is helpful for anyone showing the early signs of saggy jowls.
The real changes I noticed, however, were again on my neck, where it worked a bit like an iron on the crinkly skin, and around my eyes, where it smoothed my crow’s feet.
Keen to solve this problem too, I have also been having Profhilo Structura with Dr Acharya around my mid-face and towards my temples. This hyaluronic-acid injectable targets the superficial fat layer, supposedly supporting and remodelling adipose tissue that can diminish with ageing and weight loss.
For someone with a naturally slim face who was becoming a little hollow around my temples and mid-face, it has helped fill it out in a fresh, natural way.
Since spring 2024, after my weight plateaued, I switched from Ozempic to Mounjaro, taking 2.5mg every 12 days, which has worked well to keep me at a healthy weight.
Now, I’m back in a size 10. I remain on a 2.5mg dose of Mounjaro under medical supervision, with regular blood tests.
I’m planning to continue for now, despite the fact none of us knows or understands the long-term effects of taking weight-loss drugs yet. I also eat well, with smaller portions, no snacking and a decent serving of protein at every meal, plus lots of fruit and vegetables.
For me, Ozempic and now Mounjaro has been genuinely life-enhancing and improved my health. But I’ve also learnt that losing weight comes with compromises.
At 52, I’m not trying to look 22 but I simply want my face to reflect out how healthy and energised I feel.
What I’ve discovered is that a few carefully considered cosmetic interventions can make all the difference.
Follow Olivia on Instagram @theeditorslist
My top products for tackling ‘ozempic face’
Ozempic face is about more than the skin and fat pads. Many people notice their eyebrows becoming sparser. RevitaBrow Advanced Eye brow Conditioner claims to protect against breakage while improving flexibility, shine and fullness, resulting in more beautiful eyebrows.
This is designed to improve dull skin, uneven texture, fine lines and loss of elasticity – issues that can become more noticeable after rapid weight loss. At its core is Altum Peptide, which combines peptides with tiny needles called microspicles derived from marine sponges to deliver active ingredients into the skin. The formula also features niacinamide to brighten the complexion and support the skin barrier; adenosine to target wrinkles; and glyceryl glucoside to boost hydration. While topical skincare cannot replace lost facial volume, the serum offers a targeted approach to addressing some of the visible skin-quality changes linked with Ozempic face.
A rich hydrating cream, this targeted treatment combines eight peptides with antioxidants designed to support the skin’s microbiome, helping improve the appearance of crepiness, lines and slackness. Actress Julianne Moore is a fan.
When this inexpensive little bottle of serum was launched earlier this year, it went viral. As the only mainstream brand using the ingredient, it was revered by TikTok influencers and described as ‘filler in a bottle’, the promise being that it plumps hollowed skin and reduces fine lines. With early research suggesting the Volufiline stimulates your fat cells, I dabbed it around my temples and in the hollow pockets under my eyes as suggested for a week. Its somewhat oily texture was not unpleasant, but apart from making the area around my eyes feel nicely hydrated I think it will take many months of application before it’s worthy of its TikTok moniker.
Created by a German plastic surgeon especially for weight-loss drug users, this formula contains Kangaroo Paw Flower extract, a plant-based compound called bakuchiol and a hyaluronic-acid complex to help skin look plumper and firmer.
