Octane Aesthetics Tech Forum: Clinical Strategies for Managing Rapid Weight Loss in Aesthetics

The widespread use of GLP-1 receptor agonists (GLP-1 RAs) is ushering in a new era of aesthetic medicine that demands a more nuanced approach to skin aging, hormonal health, and treatment planning. That was the consensus from a panel of aesthetic surgeons and regenerative medicine experts at the 2026 Octane Aesthetics Tech Forum.

Panelists agreed that patients on GLP-1 RAs, such as semaglutide or tirzepatide, are presenting with new aesthetic challenges that go beyond volume loss. 

“These patients are not only sagging and hollowing—they are inducing rapid dermal aging by losing subcutaneous fat,” said Jennifer Pearlman, MD, a Canada-based expert in women’s health and regenerative aesthetics.

She emphasized that for menopausal women, GLP-1 RA use can accelerate estrogen depletion and skin aging, drawing parallels between “Ozempic face” and the facial changes of menopause.

Precision is essential, she added, especially in perimenopausal patients who may require adjunctive hormone therapy. 

“Your menopausal patient should first be on hormone optimization therapy,” she noted, citing research showing improved GLP-1 RA efficacy and safety when estrogen is restored.

Aesthetic practices are responding by developing proactive, staged approaches to care. Panelists described packaging weight loss and skin therapies together—beginning with energy-based skin tightening, biostimulators, or exosomes before visible laxity occurs. 

“We call it not just Ozempic tumor, but Ozempic prevention,” said Johnny Franco, MD, of Austin Plastic Surgery. “Most things in life improve with a proactive approach, and this is no different.”

Dan Gould, MD, a Beverly Hills, California-based plastic surgeon, has integrated GLP-1 RA prescriptions directly into his pre-surgical care model. 

“We get them started early, roll the cost into their surgery, and walk them through a year-long plan that includes check-ins, lasers, and surgical milestones,” he said. “It is a reset—floor to ceiling.”

As patients lose fat, they are also losing one of the body’s endogenous sources of estrogen, Dr. Pearlman noted. That hormonal shift has significant implications for treatment timing, skin resilience, and wound healing. Several panelists advocated for careful sequencing, particularly in patients with catabolic tendencies, to prevent overcorrection and ensure outcomes are optimized over time.