Can The “Semaglutide Sag” Be Stopped?

Top Houston Plastic Surgeon Camille Cash MD standing next to text that says "Med Spa Treatments That Help Optimize Your Semaglutide Weight Loss Results"

“Ozempic Face” and “Ozempic Butt” have sprung up as pop-culture terms to describe the aesthetic concerns experienced by some who use semaglutide (the active ingredient in Ozempic® and Wegovy®) for rapid weight loss. These viral expressions were coined to describe loose skin and volume loss in the face and gluteal regions in particular.

In reality, any form of substantial and rapid weight loss can lead to these aesthetic concerns and semaglutide does not disproportionately target the face and buttocks – volume loss can occur anywhere throughout the body. Also, not everyone will experience these unintended side effects.  People who have been overweight for a long time, or have significant amount of weight to lose, are more likely to experience sagging as a consequence of their skin having been been stretched out to a greater extent, for a longer period of time. Some studies[1] have found that semaglutide may lead to a decrease in muscle mass, in addition to fat loss, leaving those who do not exercise or consume enough protein to support their muscles at a higher risk for loose skin and volume loss in unwanted areas.

Genetics and skin type play a role as well. Those with oiler skin, which tends to be better hydrated, are typically less prone to skin laxity issues. Younger patients tend to bounce back better than older patients because of greater amounts of collagen and elastin which make skin more resilient.

But for those who are concerned with skin laxity and volume brought on by rapid weight loss, we offer many options to help. While surgery is always an option, it’s important to know that you would need to be off any semaglutide medication for several weeks before and after surgery due to increased anesthesia risks and to ensure that the body receives the nutrition it needs in order to heal properly. That’s why non-invasive and minimally invasive treatments, which can be performed safely and concurrently throughout one’s weight loss journey, are highly recommended.

Evolve and Evoke:

Collagen and elastin are two essential proteins that give your skin its elasticity or ability to retract and adapt to weight loss. Evoke (for the face and neck) & EvolveX (for the body) use radiofrequency (RF) to trigger skin cells to tighten as collagen and elastic production is stimulated. We recommend these two radiofrequency treatments as a proactive measure to help defend against loose sagging skin that can be performed safely while on semaglutide or similar GLP-1 medications.

Evolve Tone can also help with “Ozempic Butt” by using electrical muscle stimulation (EMS) technology to generate rapid, involuntary muscle contractions that strengthen, build, and define muscles. Treatments can be performed on the buttocks, abdomen, arms, and thighs.

Morpheus 8:

Whereas Evolve and Evoke are completely non-invasive, allowing you to multitask throughout the painless hands-free sessions, Morpheus8 is a powerful minimally-invasive treatment that combines the benefits of radiofrequency with microneedling. By penetrating to the deeper layers of the skin, Morpheus8 is able to heat the dermis, to remodel the tissue in the dermis and sub-dermis to generate new collagen to result in smoother, firmer skin on the face, neck, and body.

FaceTite and BodyTite

FaceTite and BodyTite take nonsurgical skin tightening to the next level by simultaneously emitting radiofrequency energy (RF) both above and beneath the skin. This configuration allows the device to safely deliver a higher level of energy than other skin tightening devices that only affect the outside or inside of the skin. Patients are awake during treatment, performed in the comfort of my Houston surgical suite, and are kept comfortable with the use of a local anesthetic and the option for conscious sedation. The treatment ends with Morpheus 8 microneedling and some use the term “EmbraceRF” in reference to combining a FaceTite / BodyTite with a Morpheus 8 treatment.  Unlike the other radio frequency treatments available at my Medical Spa, patients typically only need 1 session of FaceTite / BodyTite to achieve full results.


I love using filler to restore lost volume of the face and buttocks (“liquid BBL”). But if you are considering the use of radiofrequency treatments AND fillers, its crucial to coordinate scheduling accordingly. Patients should wait at least one month after getting filler before having a Morpheus8 or Evoke treatment. While it’s possible to have a filler treatment immediately after receiving your final Evoke treatment, we advise patient to wait at least 24 hours after your Evoke treatment to be on the safe side.  We recommend waiting at least 2 weeks after a Morpheus8 treatment to have a filler injection.  Fillers and FaceTite can be done on the same day with FaceTite being performed first, followed by filler.

A “Liquid BBL” with fillers can be a particularly great option for patients on semaglutide since the fillers used do not metabolize the way fat does. Ideally Evolve Tone treatments would be performed before vs after a liquid BBL but the order is not as consequential in comparison to the aforementioned treatment combinations.


If you are considering starting my #CashedOut semaglutide program for rapid weight loss, it’s important to be mindful of the fact that skin laxity and loss of facial or gluteal volume are a possibility, although not an inevitability. I offer several MedSpa treatments to help counteract these aesthetic concerns. It is important to have realistic expectations for what can be achieved without the use of a scalpel but some additional benefits of non-surgical options are the little-to-no downtime and little-to-no scarring involved. Enhancing the results of non-surgical treatments with surgery later down the line can yield cumulative benefits for your newly trimmed figure.  To discuss all your options, and help determine the best pathways for you, call our Houston, TX, office today at (713) 893-8852 or request a consultation online.


Leave a Reply

Fields marked with * are required.