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My first encounter with ‘Ozempic face’ was brutal. It came in the form of a photograph a friend sent me on WhatsApp after a party we had both attended.
In the picture, I was smiling broadly and looking slimmer than I had in years. But then I noticed something else.
Why were two peculiar, sausage-like bulges sitting beneath my eyes? And what had happened to my neck? The skin looked crepey and loose.
Actress Catherine Deneuve once observed that a point comes in every woman’s life when she must choose between her face and her backside.
But I didn’t want to make that choice. Like thousands of women across the country, I had noticed my expanding middle-aged waistline and decided to do something about it. I started taking weight-loss injections, only to find that my face appeared to have paid the price.
That is why I was fascinated by news earlier this month that Croda, the 100-year-old British chemicals company, had repurposed an old skin-plumping compound specifically to address the hollow, sagging appearance associated with ‘Ozempic face’.
Derived from the root of the Chinese plant anemarrhena, Volufiline was once used in body creams, although it achieved only limited commercial success. Now, after being linked with an ability to counter the gaunt facial appearance that can follow rapid weight loss, it has become a beauty-industry sensation.
TikTok has crowned Volufiline an ‘it’ ingredient, while skincare company The Ordinary launched the first High Street serum containing it this year. French and Korean brands are rushing to develop their own products, and Croda’s share price, which had languished earlier this year, is now climbing.
I only wish I had heard about it in 2023, when I was first prescribed Ozempic.
It was not a decision I made casually. In April that year, weighing a little over 11st, I had begun to feel unwell. I was approaching a size 14 despite having always been a size 10, and at 48 I was perimenopausal, uncomfortable and bloated.
Like thousands of women across the country, I noticed my growing middle-aged spread and turned to weight-loss injections. But my face suffered as a result, 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 my health rather than my appearance. I was suffering from debilitating lower-back pain, and blood tests showed that I was prediabetic and had high cholesterol, with a reading of 6.6 compared with NHS guidance recommending a level below 5. My two daughters, then 11 and 12, kept me constantly busy, and I did not want to enter middle age with the energy levels of an old person.
The weight gain had also affected my confidence. I have always enjoyed fashion and spent four years at Vogue as assistant to then-editor Alexandra Shulman before becoming beauty editor at Tatler.
Looking fit and healthy has always been part of the job. Yet instead of wearing my favourite structured Roland Mouret dresses and tailored trousers, I had retreated into loose Zara dresses. I wanted to feel like myself again.
For six months, I resisted weight-loss injections and tried supplements, extra exercise and help from a nutritionist. But every pound I lost by avoiding pasta and exercising returned as soon as my self-discipline faltered.
Eventually, I arranged a medical assessment with private doctor Wendy Denning at Health Doctors in Devonshire Place, central London. After a thorough consultation, including blood tests, a thyroid examination, BMI measurement and a detailed medical history, she prescribed Ozempic.
This was relatively early in the development of weight-loss injections, and I knew only a few people who were taking them. I was certainly nervous: I am the kind of person who would rather endure a headache than take a paracetamol. However, I trusted Wendy and began on 0.25mg before increasing to 0.5mg after four months.
Taking a relatively gradual approach meant I avoided the common side-effects of nausea and constipation, while losing the stubborn 7kg — just over a stone — over six months.
I also noticed marked changes in my face. I have always had a fairly long, narrow face, and I suspect the effects became visible sooner than they might have done in someone with a rounder face.
There was not much spare fat to lose, so fullness quickly gave way to hollowness. Dermatologist Dr Lindsey Bordone explains it simply: ‘Anyone who loses weight quickly notices changes in their face.’
When facial fullness decreases, the skin can appear looser and lines may become more pronounced. Ageing was also inevitably playing a role in my midlife skin. The medication was not responsible for every change, but it certainly did not help.
I did not think my face was sagging enough to justify surgery, but the problem beneath my eyes required a closer look.
About a week after the discovery of my ‘sausage eyes’, I visited Dr Munir Somji at his Dr MediSpa clinic in Knightsbridge. He examined the area using a handheld ultrasound device and identified what was happening.
As I lost weight, the fat pads beneath my eyes had reduced. This exposed and allowed old under-eye filler — injected five years earlier — to shift and migrate downwards.
It is a recognised problem. When facial fat diminishes, the cushioning and camouflage around filler are reduced, leaving behind conspicuous rolls and lumps.
Ozempic, followed by Mounjaro, has genuinely improved my life and health. But I have also learned that weight loss can involve compromises
Dr Somji treated the problem with hyaluronidase, an enzyme that dissolves the hyaluronic acid in dermal filler. The improvement was immediate: the sausage-like bulges flattened.
Then there was my neck. Often described as the starting point for visible ageing, the neck has thinner skin than many parts of the face. Mine was a textbook example of the gauntness that can follow weight loss injections.
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As founder of The Editor’s List, a cosmetic concierge service that guides clients towards leading cosmetic doctors and surgeons worldwide, I am fortunate to have access to expert advice.
Dr Paris Acharya, who has an exceptionally light touch and a discerning eye, introduced me to an injectable treatment called a Radiesse wash. Radiesse is a gel filler containing tiny calcium hydroxylapatite particles, a mineral found in bone and commonly used in dentistry.
When diluted significantly and delivered beneath the skin with a cannula, it is designed to stimulate collagen and improve skin quality rather than simply add volume. I think of it as helping to build fresh support beneath thinning skin.
I thought I could see an improvement after one treatment, which was fortunate because each session costs about £500. However, collagen regeneration takes at least six weeks.
The number of treatments and the duration of results vary. Two sessions, usually around six weeks apart, are often advised, with the effects lasting approximately 18 months.
I had the treatment about 14 months ago and was pleased with the results, although the crepey appearance has recently begun to return. To maintain the improvement and make my neck look less straggly, I recently tried XERF, a treatment popular with Kim Kardashian, with Dr Nyla Raja at her clinic in Mayfair, west London.
The radiofrequency device, which arrived in UK clinics last month, applies controlled heat beneath the skin. It is intended to encourage collagen remodelling and improve firmness, making it potentially useful for early sagging around the jawline.
The most noticeable changes for me were once again on my neck, where the treatment seemed to smooth the crinkled skin much like an iron, and around my eyes, where it softened my crow’s feet.
I have also been using Profhilo Structura with Dr Acharya across my mid-face and towards my temples. This hyaluronic-acid injectable targets the superficial fat layer and is intended to support and remodel adipose tissue that can diminish with ageing and weight loss.
Because my face is naturally slim and had begun to look slightly hollow around the temples and mid-face, the treatment has restored some fullness in a fresh and natural-looking way.
After my weight stabilised in spring 2024, I changed from Ozempic to Mounjaro. I take 2.5mg every 12 days, which has worked well in helping me maintain a healthy weight.
I am now back in a size 10 and remain on a 2.5mg dose of Mounjaro under medical supervision, with regular blood tests.
For the moment, I plan to continue, although the long-term effects of weight-loss drugs are not yet fully known or understood. I also eat sensibly, choosing smaller portions, avoiding snacks and including a good serving of protein at every meal, alongside plenty of fruit and vegetables.
For me, Ozempic and now Mounjaro have been genuinely life-enhancing and have improved my health. But I have also learned that losing weight can involve trade-offs.
At 52, I am not trying to look 22. I simply want my face to reflect how healthy and energised I feel.
What I have discovered is that a few carefully chosen cosmetic treatments can make a significant difference.
Follow Olivia on Instagram @theeditorslist
My favourite products for tackling ‘Ozempic face’
‘Ozempic face’ involves more than changes to the skin and facial fat pads. Many people also notice thinner eyebrows. RevitaBrow Advanced Eyebrow Conditioner claims to help protect against breakage while improving flexibility, shine and fullness for more defined-looking brows.
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This serum is designed to target dullness, uneven texture, fine lines and reduced elasticity — concerns that may become more obvious after rapid weight loss. Its key ingredient, Altum Peptide, combines peptides with tiny marine-sponge needles known as microspicules to help deliver active ingredients into the skin. It also contains niacinamide to brighten the complexion and support the skin barrier, adenosine to target wrinkles and glyceryl glucoside to improve hydration. While topical skincare cannot restore lost facial volume, the formula offers a targeted way to address some visible changes in skin quality associated with ‘Ozempic face’.
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This rich moisturising cream combines eight peptides with antioxidants intended to support the skin microbiome while improving the appearance of crepiness, fine lines and slackness. Actress Julianne Moore is a fan.
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When this affordable serum launched earlier this year, it quickly went viral. As the only mainstream brand using the ingredient, it attracted TikTok influencers and was dubbed ‘filler in a bottle’, with claims that it could plump hollow-looking skin and soften fine lines. Early research suggests that Volufiline may stimulate fat cells, so I applied it for a week to my temples and the hollows beneath my eyes, as advised. Its slightly oily texture was not unpleasant, but aside from leaving the eye area feeling well hydrated, I suspect it would take months of use before it lived up to its TikTok nickname.
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Developed by a German plastic surgeon specifically for people using weight-loss drugs, this formula contains Kangaroo Paw Flower extract, the plant-derived ingredient bakuchiol and a hyaluronic-acid complex intended to leave skin looking fuller and firmer.
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by plastic surgeon Mr William Townley
For patients with pronounced sagging across the lower face and neck, a deep-plane facelift combined with a neck lift can provide the most comprehensive correction.
The procedure is designed to reposition supporting tissue without simply pulling the skin tight. Incisions are made around the ears and sometimes beneath the chin, allowing the surgeon to release the facial ligaments connecting tissue to bone and lift the cheeks and jowls.
It addresses excess skin and can restore definition beneath the chin and along the jawline. A lift cannot replace lost facial volume, however, which is where a patient’s own fat may be beneficial.
I prefer the area above the inner knees as a donor site because I find the fat there provides useful structure and support. The tummy and flanks are alternatives. Fat is collected through liposuction and then processed.
Microfat — fat containing small parcels of fat cells — is introduced through fine cannulas to restore volume in the temples, cheeks and under-eye area. It may also improve skin quality.
Nanofat undergoes more extensive processing to create an almost liquid preparation with a serum-like appearance. Its purpose is to improve skin quality and texture through its potential regenerative properties.
These are surgical procedures and require recovery time, with further treatment sometimes necessary. Risks associated with lifting include bleeding, infection, unevenness and nerve damage. Fat injections also carry rare vascular risks, including loss of sight.
