Beyond the Scale: How Aesthetic Treatments Address What GLP-1 Medications Leave Behind

GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have fundamentally changed how Canadians manage both type 2 diabetes and weight. Ozempic and Mounjaro were originally approved for blood sugar management; Wegovy and Zepbound followed as dedicated weight-management formulations. Regardless of the indication, significant weight loss is a common outcome—patients typically lose 15–22% of their body weight within the first year of treatment.^[19]

The scale of adoption in Canada is substantial. More than 8.7 million Canadian adults live with obesity and nearly 60% of the adult population is overweight or obese,^[1] while approximately 3.4 million Canadians (8.9% of the population) have been diagnosed with diabetes.^[2] Since Health Canada approved Ozempic in January 2018, GLP-1 prescriptions have surged—weight-management drugs now rank among the top categories in Canadian private drug plans, with a 61% year-over-year increase in claims.^[3]

But weight loss—whether it was the goal or a side effect of diabetes management—changes more than the number on the scale. Patients are discovering what clinicians have long understood: the skin, once stretched, does not always snap back.

This has given rise to what the media calls "Ozempic face" and "Ozempic body"—the visible consequences of fat loss outpacing the skin's ability to remodel. For many patients, reaching their goal weight is the beginning of a new chapter in appearance management, not the end.

A new patient population is entering aesthetic medicine

What makes this moment particularly significant for clinics like ours is who these patients are. According to a 2025 McKinsey survey of 174 aesthetic providers across North America, 63% of GLP-1 patients seeking facial treatments have never been active cosmetic medicine users before.^[5] These are people who would not have walked into an aesthetic clinic a year ago. Their weight loss journey brought them here.

The trend is continental: 70% of consumers are now considering a cosmetic dermatologic procedure, and 85% of those surveyed cite excess or changing body composition as their primary aesthetic concern.^[6] With Zepbound (tirzepatide for weight management) arriving in Canada in mid-2025 and generic semaglutide anticipated by late 2026, the pipeline of patients experiencing post-weight-loss skin changes will only grow.^[3]

What happens to skin during medication-driven weight loss

To understand why these treatments work, it helps to understand what GLP-1 medications do to the skin beyond simple fat reduction.

Skin laxity and volume loss. The Nikolis et al. Delphi consensus found that the tissue layers most significantly affected in medication-driven weight loss are the skin itself (significant impact in 70% of cases) and both superficial and deep fat pads (50–70%).^[9] Separately, the Allergan Aesthetics survey reported that 61% of GLP-1 patients experience midface volume loss and 50% report skin laxity.^[4]

Dehydration. GLP-1 medications can suppress thirst signalling, and clinicians have reported that patients on these medications frequently present with dehydrated skin.^[7][8]

Barrier disruption. Weight loss reduces the subcutaneous fat layer, which can affect the skin's lipid barrier function, contributing to dryness and sensitivity.^[8]

The first international Delphi consensus on managing aesthetic concerns in medication-driven weight loss patients was led by Dr. Andreas Nikolis of McGill University in Montréal and published in the Journal of Cosmetic Dermatology in April 2025. The consensus confirmed that these skin changes are typically mild-to-moderate in severity—unlike the more extreme laxity seen after bariatric surgery—making them well-suited to non-surgical, energy-based treatments.^[9] Canadian researchers are not just following this field—they are defining its clinical standards.

Critically, the consensus panel found that non-surgical treatments including microneedling, laser therapy, and professional-grade facials can begin concurrently with active weight loss—patients do not need to wait until they reach their goal weight to start restoring their skin.^[9]

Four treatments that address post-GLP-1 skin concerns

At IVONNE^®, we approach post-weight-loss skin restoration with a combination of technologies, each targeting different layers and mechanisms of skin ageing and laxity. Here is how each one works—and what the clinical evidence shows.

1. Microneedling—Collagen Induction Therapy

Microneedling creates thousands of precise, controlled micro-channels in the skin, triggering the body's natural wound-healing cascade. Approximately five days post-treatment, beta-fibroblasts lay down a fibronectin matrix that serves as the scaffold for new collagen deposition. This new collagen—predominantly types I and III—remains structurally intact for five to seven years before naturally turning over.^[10]

The Nikolis consensus panel specifically identified microneedling among the energy-based devices recommended for use in medication-driven weight loss patients.^[9]

Clinical evidence: A study of 42 patients receiving radiofrequency-assisted microneedling for skin laxity reported a 95% response rate with a mean improvement of 24.1% in measured laxity at six months.^[11]

• Stimulates new collagen and elastin production in the dermis
• Improves skin texture, firmness, and overall tone
• Enhances absorption of topical active ingredients by up to 80%
• Minimal downtime (typically 24–48 hours of mild redness)

2. Hydrafacial®—Hydration and Barrier Restoration

Clinicians report that patients on GLP-1 medications frequently present with dehydrated, dull skin—consistent with the thirst suppression and lipid barrier changes documented in these patients.^[7][8] The Nikolis consensus panel included facials among the non-surgical treatments recommended for concurrent use during medication-driven weight loss.^[9]

Hydrafacial® combines cleansing, exfoliation, extraction, and hydration delivery in a single treatment. Its patented vortex delivery system enhances product absorption by up to 300% compared to manual topical application,^[12] driving hydrating serums, peptides, and antioxidants into the skin at depths that surface application cannot reach.

Clinical evidence: While Hydrafacial® has not been studied specifically in GLP-1 patient populations, general clinical data is compelling. A 2018 clinical study found that participants experienced an average 70% improvement in skin hydration levels following regular treatments over 12 weeks.^[12] A subsequent 2023 study demonstrated that monthly treatments over six months produced a 50% improvement in the skin's moisture-retention capacity, with patients 30% less likely to experience dryness and environmental sensitivity between sessions.^[13]

• Clinically demonstrated improvement in skin hydration and barrier function
• Immediate visible improvement in skin radiance and texture
• Zero downtime—patients return to normal activities immediately
• Recommended as a concurrent treatment during active weight loss by the Nikolis consensus panel^[9]

3. PicoWay®—Picosecond Laser Rejuvenation

The Candela PicoWay® delivers ultra-short picosecond laser pulses—each lasting just trillionths of a second—that create tiny vacuoles beneath the skin's surface through a process called laser-induced optical breakdown (LIOB). These microscopic empty spaces trigger the body's healing response without ablating or damaging the skin's surface, resulting in new collagen and elastin formation from the inside out. The Nikolis consensus panel included laser therapy among the energy-based devices recommended for medication-driven weight loss patients.^[9]

Clinical evidence for rejuvenation: Histological studies confirm that PicoWay® treatment produces increased density and elongation of elastin fibres, along with measurable collagen III and mucin deposition at three-month follow-up.^[14] In wrinkle reduction studies, Fitzpatrick wrinkle scores improved from 5.48 to 3.47 at six months.^[15]

Clinical evidence for pigmentation: 87% of patients with pigmented lesions reported a good response after just two treatments.^[15] A 2026 study in Lasers in Surgery and Medicine confirmed that picosecond lasers achieve active phagocytosis of pigment debris with significant downregulation of tyrosinase expression—the enzyme responsible for melanin production.^[16] Note: these pigmentation studies were conducted on general dermatology patients, not specifically post-weight-loss populations.

• Collagen and elastin stimulation with histological confirmation
• Non-ablative—treats below the surface without damaging the epidermis
• 30% average reduction in pore volume at six months^[15]
• Safe across all skin types with multiple wavelength options (755nm, 1064nm)

4. GentleMax Pro Plus®—Dual-Wavelength Laser Skin Tightening

The Candela GentleMax Pro Plus® combines two laser wavelengths in a single platform: the 755nm Alexandrite laser and the 1064nm Nd:YAG laser. The Nd:YAG wavelength penetrates deep into the dermis, delivering controlled thermal energy that triggers neocollagenesis (the synthesis of new collagen) without injuring the skin's surface. As with PicoWay®, the Nikolis consensus supports laser-based energy devices for medication-driven weight loss patients.^[9]

Clinical evidence: Studies on the long-pulsed 1064nm Nd:YAG for skin tightening—conducted on general dermatology patients with skin laxity, not specifically post-GLP-1 populations—demonstrated an average wrinkle grade reduction of 45.1% four weeks after the final treatment session. On the Global Aesthetic Improvement Scale, 94% of patients rated their results as improved, much improved, or very much improved.^[17] Histological examination confirmed increased collagen and elastic fibre density in the papillary dermis, with the greatest gains observed after four treatment sessions.^[17]

The dual-wavelength design means this single platform addresses multiple concerns: skin laxity and tightening (Nd:YAG), pigmentation irregularities (Alexandrite), and vascular changes—all with an average patient-reported pain score of just 2.6 out of 10.^[18]

• Non-ablative deep dermal heating stimulates collagen and elastin production
• Dual wavelength treats laxity, pigmentation, and vascular concerns in one platform
• Zero downtime—patients return to all activities immediately
• Safe for all skin types (Fitzpatrick I–VI) with the Nd:YAG wavelength
• Comfortable treatment with integrated Dynamic Cooling Device

A layered approach: why combination matters

No single treatment addresses every dimension of post-GLP-1 skin change. The clinical consensus supports what we see in practice: the best outcomes come from combining modalities that work at different depths and through different biological mechanisms.

Starting the conversation

If you are currently taking or considering a GLP-1 medication, or if you have already achieved significant weight loss and are noticing changes in your skin's firmness, texture, or tone, a professional assessment can help determine which combination of treatments will best support your skin as your body transforms.

The Nikolis consensus is clear: you do not need to wait until you reach your goal weight to begin addressing skin concerns. The panel recommends that non-surgical treatments can begin concurrently with active medication-driven weight loss.^[9]

Up to 50% of patients on GLP-1 medications experience some weight regain within the first year of discontinuation,^[9] which is one reason non-surgical, repeatable treatments are a pragmatic choice: they adapt with you, regardless of where your weight journey leads.

References

1. Statistics Canada. "Body mass index, overweight or obese, self-reported, adult, by age group." Canadian Community Health Survey, Table 13-10-0096-01, 2022.
2. Public Health Agency of Canada. "Diabetes in Canada: Highlights from the Canadian Chronic Disease Surveillance System." PHAC, 2022.
3. Telus Health. "2025 Annual Drug Trends Report." Via Benefits Canada, 2025.
4. Allergan Aesthetics (AbbVie). "Medical Weight Loss Patient Data: The Changing Profile of Aesthetic Patients." Presented at ASDS Annual Meeting 2025; published Aesthetic Surgery Journal Open Forum, January 2026.
5. McKinsey & Company. "GLP-1s Are Boosting Demand for Medical Aesthetics." McKinsey Life Sciences Practice, 2025. Survey of 174 aesthetic providers.
6. American Society for Dermatologic Surgery (ASDS). "2025 Consumer Survey on Cosmetic Dermatologic Procedures." Survey of 3,500+ consumers, 2025.
7. skinbetter science. "The Effects of GLP-1 Medications on Skin: What You Need to Know." skinbetter science Clinical Blog, 2025.
8. Shore Dermatology. "GLP-1 Weight Loss Drugs and Your Skin." Clinical Advisory, 2025.
9. Nikolis A, Safran T, et al. "Consensus Statements on Managing Aesthetic Needs in Prescription Medication-Driven Weight Loss Patients: An International, Multidisciplinary Delphi Study." Journal of Cosmetic Dermatology, April 2025. DOI: 10.1111/jocd.70094. Lead author: Division of Plastic and Reconstructive Surgery, McGill University, Montréal.
10. Fernandes D, Signorini M. "Comprehensive Review of Microneedling: Mechanisms, Applications, and Clinical Outcomes." PMC, 2024. See also: Hou A, et al. "Microneedling: A Means of Collagen Induction Therapy." Journal of Dermatology and Dermatologic Surgery, 2021; 25(2):61-66.
11. Weiss RA, et al. "Subcutaneous Radiofrequency Microneedling for Thigh Skin Laxity After Weight Loss." Journal of Clinical and Aesthetic Dermatology, 2019; 12(7):28-32.
12. Mauricio T. "Clinical Outcomes of HydraFacial Treatment: A 12-Week Hydration Study." Presented 2018.
13. Costeloe K, Newman A. "Long-Term Skin Hydration and Barrier Function Improvements with Monthly HydraFacial Treatments: A 6-Month Study." 2023.
14. Haimovic A, et al. "Histological Investigation of Picosecond Laser-Toning." Lasers in Surgery and Medicine, 2020. PMC7447825.
15. Lee YJ, et al. "Update on Fractional Picosecond Laser Treatment: Histology and Clinical Applications." Journal of Clinical Medicine, 2023. PMC9852188.
16. Wang Y, et al. "Picosecond Laser-Induced Optical Breakdown and Pigment Phagocytosis: A Porcine Model Study." Lasers in Surgery and Medicine, 2026. DOI: 10.1002/lsm.70084.
17. Hong JS, et al. "Long-Pulsed 1064nm Nd:YAG Laser Treatment for Skin Laxity: Clinical and Histological Evaluation." International Journal of Dermatology, 2015; 54(6):662-668.
18. Kim JE, et al. "Efficacy and Safety of Long Pulse 1064nm and 2940nm Lasers for Skin Tightening." PMC, 2020. PMC7065637.
19. Jastreboff AM, et al. "Tirzepatide Once Weekly for the Treatment of Obesity." New England Journal of Medicine, 2022; 387:205-216 (SURMOUNT-1). Wilding JPH, et al. "Once-Weekly Semaglutide in Adults with Overweight or Obesity." NEJM, 2021; 384:989-1002 (STEP 1).

There are always risks related to the use of any skincare or cosmetic product or treatment and the results are never guaranteed.