The �Ozempic Face� Effect: Shifts In U.s. Demand For Fillers And Contouring Procedures In The Glp-1 Era

Background: Glucagon-like peptide-1 (GLP-1) receptor agonists such as Ozempic and Wegovy have surged in popularity for medical and off-label cosmetic weight loss. Rapid fat loss has intensified concern over facial deflation and skin laxity, commonly termed "Ozempic face." Understanding shifts in public interest for aesthetic procedures is critical for informing patient counseling, practice planning, and training priorities. Purpose: To analyze changes in public search interest in aesthetic procedures before and after the rise of GLP-1 medications, using Google Trends data as a proxy for shifting aesthetic concerns. Methods: We conducted a retrospective Google Trends analysis of U.S. public interest in aesthetic procedures from January 2018 to March 2025. Fourteen search terms were categorized into three groups: facial fillers, body contouring, and fat-related procedures. We compared search interest in these terms between the pre-GLP-1 era (2018-2020) and the post-GLP-1 era (2021-2025), examining temporal trends for individual terms, shifts in the top search terms within each category, and geographical variation in the five leading facial filler terms in major metropolitan areas across seven states. Analyses included two-sample t-tests for pre/post mean differences with 95% confidence intervals, post/pre mean ratios on the log scale, and interrupted time-series regressions anchored at January 2021 with Newey-West standard errors. The Benjamini-Hochberg false discovery rate (α=0.05) was used to control for multiple comparisons. Results: The emergence of GLP-1 drugs correlated with significant changes in public interest. The largest absolute increases were seen for cheek filler (+26), Brazilian butt lift (+25), under-eye filler (+14), and dermal filler (+14). Under-eye filler dominated most major U.S. metropolitan areas, while 18% of smaller and mid-tier markets shifted toward cheek or chin fillers, concentrated in parts of Texas, upstate New York, and selected Midwest regions. Across all metropolitan areas, the filling-to-lifting ratio increased, with the largest shifts in coastal markets (LA, Miami, NYC), reflecting preference for minimally invasive volume correction over surgical lifting. Interrupted time series analysis revealed that while many procedures surged initially in 2021, most stabilized by 2023 except facial fat transfer (+0.69 slope change, p0.001), which continued accelerating. Among lifting procedures, facelift searches increased modestly (RR=1.26, 95% CI 1.21-1.31), while body lift declined (RR=0.93, 0.89-0.98). Conclusion: The rise of GLP-1 medications has driven sustained demand for under-eye and cheek fillers, with little shift toward surgical lifting despite skin laxity concerns. Facial fat transfer continues to accelerate, suggesting a growing preference for autologous volume restoration. These patterns may reflect GLP-1-mediated lipolysis that disproportionately affects superficial and medial cheek fat pads while sparing deeper structural layers. Further study using imaging or tissue sampling in GLP-1 users undergoing facelift or blepharoplasty could clarify these compartment-specific effects. Geographically, coastal hubs such as Los Angeles, Miami, and New York remained dominated by under-eye filler, reflecting a more standardized aesthetic ideal, whereas mid-tier markets increasingly favored cheek and chin fillers, emphasizing restoration of individual facial contours. Recognizing these anatomic and geographic trends can inform patient counseling, guide procedural training, and optimize resource allocation in the evolving aesthetic landscape. *Source: https://ps-rc.org/meeting/Program/2026/EP04.cgi*