The phrase “Ozempic face” gets thrown around like it’s an unavoidable side effect. In reality, what patients are noticing is far more specific and far more fixable. As facial volume diminishes, areas like the cheeks, temples and jawline can look less cushioned, making fine lines, texture and laxity more noticeable. That’s where collagen enters the conversation.
“The main issue isn’t the medication, but the speed and biology of fat loss,” says Chicago dermatologist Jessie Cheung, MD. Fat, she explains, isn’t just padding. It’s part of the skin’s support system, tied to stem cells, growth factors and hormones. “When it goes fast, collagen production slows down even more, making it harder for your skin to bounce back.”
What happens next is often a waiting game. With less underlying support, the skin doesn’t rebound on its own overnight. “That’s when underlying laxity becomes more visible,” Dr. Cheung says, noting that pores and fine lines can feel louder during this phase. It’s also why collagen becomes the real focus. Collagen isn’t an instant upgrade—it’s a rebuilding process, and the skin needs both the right materials and time to strengthen again.
Ahead, we’re breaking down what’s really happening to collagen during weight loss, why creams and powders fall short and which treatments can actually help.
Featured Experts
- Jessie Cheung, MD is a board-certified dermatologist in Chicago
- Marina Peredo, MD is a board-certified dermatologist in New York
Where Powders and Creams Fall Short
When skin starts to change, many patients turn first to collagen powders, supplements or tightening creams. Dermatologists say those products tend to get a lot of attention, but not because they deliver true collagen rebuilding. “Over-the-counter ‘collagen’ or skin-tightening creams can help with hydration,” says New York dermatologist Marina Peredo, MD, “but collagen molecules are too large to penetrate the skin, so they don’t actually rebuild collagen or tighten tissue.”
Dr. Cheung sees the same pattern with products marketed specifically for GLP-1–related sagging. “So-called miracle creams may make skin feel smoother,” she says, “but they can’t replace lost volume or rebuild deep collagen.” For real structural change, experts point patients toward in-office treatments.
Treatments That Actually Move the Needle
Dr. Cheung’s approach is layered and intentionally sequenced. “My approach is about re-establishing cell signaling and structure,” she says. “Microneedling with boosters like PRP or PDGF, exosomes and polynucleotides works well for GLP-1 patients because it wakes up the skin’s repair cells and supplies the building blocks for rebuilding collagen,” she explains.
From there, she builds deeper support with devices. “I layer this with energy-based treatments like ultrasound and radiofrequency to stimulate collagen deeper in the skin,” she says, bringing in lasers later “for texture and tone, once the skin is stronger.”
Ultrasound-based skin tightening, such as Ultherapy PRIME and Sofwave, is often part of that collagen conversation, particularly for patients who notice laxity rather than volume loss. Dr. Peredo frequently uses ultrasound in her GLP-1 patients for that reason. “Ultrasound is excellent for stimulating collagen remodeling without adding volume,” she says. “It delivers controlled ultrasound energy to the mid-dermis, which helps firm the skin while preserving natural movement.”
Injectables That Support Collagen
Injectables can also support collagen rebuilding when used thoughtfully. “Biostimulatory injectables encourage your body to produce its own collagen,” Dr. Cheung says. “They’re not plug-and-play, especially in GLP-1 patients.” Her ideal candidates are patients with early volume loss, realistic expectations and, importantly, adequate nutrition.
Timing also matters. “Sculptra works by creating a controlled inflammatory response,” she explains. “Since GLP-1s reduce inflammation, we’re still learning how those treatments perform in patients actively on medication.” In those cases, she notes that hyperdiluted Radiesse can be a reliable option. “It can improve skin quality and elasticity, particularly when laxity is the main concern.”
Nutrition Still Matters
Even with the most thoughtful in-office plan, dermatologists stress that collagen rebuilding doesn’t happen in isolation. “Getting enough protein is key,” Dr. Cheung says, noting that skin and muscle are closely linked during weight loss. When protein intake drops too low, the skin simply doesn’t have the raw materials it needs to repair itself.
She also emphasizes the role of supportive nutrients. Vitamins B, C and D, along with zinc, help drive the repair processes that allow new collagen to form, while copper GHK peptides can support elasticity as the skin adjusts to its new framework.
The Bigger Picture
The takeaway is less dramatic than the headlines suggest. When weight loss shifts the proportions of your face, the solution isn’t panic and it isn’t chasing the latest collagen powder or tightening cream either. It’s a longer view that treats collagen for what it really is: a structural protein your body builds gradually, in response to the right signals.
For patients on GLP-1s, that often means pairing smart nutrition with in-office treatments that work with the skin, not against it, and allowing time for those changes to take hold. When collagen is supported intentionally, skin quality doesn’t have to be the trade-off of successful weight loss. It simply becomes part of the plan.
