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Beyond Weight Loss: Facial Remodeling Associated with GLP-1 Receptor Agonists-A Systematic Review and Therapeutic
Fabio Maglitto1, Giovanni Salzano1, Serena Trotta2
1Department of Maxillofacial Surgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
Background:
Facial volume depletion and skin laxity have increasingly been reported during weight loss associated with glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment. However, these changes are not recognized as a distinct clinical entity and may overlap with those occurring after other forms of rapid or massive weight loss. Evidence regarding their treatment remains limited.
Methods:
This systematic review was conducted according to PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261415797). PubMed/MEDLINE, Embase, and Scopus were searched from inception to June 5, 2026. Clinical studies evaluating interventions for facial changes associated with GLP-1RA-related weight loss were included. Study characteristics, interventions, outcomes, safety, and methodological limitations were synthesized narratively. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools.
Results:
Four uncontrolled observational studies involving 98 treated participants met the eligibility criteria. Two studies enrolled exclusively patients receiving GLP-1RAs or related incretin-based medications, whereas two included mixed weight-loss etiologies. Investigated interventions included injectable biostimulators and fillers, endotissutal bipolar radiofrequency, and a topical formulation. All studies reported favorable within-group findings; however, heterogeneous populations, weight-loss trajectories, interventions, outcomes, and follow-up durations, together with the absence of comparator groups, precluded conclusions regarding treatment effectiveness or superiority.
Conclusions:
The available evidence is preliminary and insufficient to support a validated therapeutic algorithm. The proposed framework is hypothesis-generating and integrates limited review findings with established principles of post-weight-loss facial rejuvenation. Comparative studies evaluating surgical and nonsurgical interventions are required.
Level Of Evidence V:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Trial registration number PROSPERO Registration CRD420261415797.
