Fat, Architecture, and Cervical Evaluation (FACE) Framework to Assess GLP-1 Receptor Agonist-Associated Face and Neck Changes and Guide Treatment Selection
Shaishav Datta, Elie P RamlyAbstract
Background
Glucagon-like peptide-1 receptor agonists (GLP-1RA) are increasingly being used for weight loss, leading plastic surgeons to encounter a growing population of patients with facial and cervical changes colloquially described as “Ozempic face” and “Ozempic neck.” Existing facial aging and post-massive weight loss frameworks may not fully capture this phenotype.
Objectives
To define recurring morphologic patterns, perioperative considerations, and treatment implications of GLP-1RA-associated facial and cervical change.
Methods
A narrative review was performed using PubMed, Embase, and MEDLINE from database inception through January 2026. Full-text English-language human studies addressing GLP-1RA-associated facial aesthetic change, facial rejuvenation, rhytidectomy, neck lift, or relevant anatomic concepts were reviewed.
Results
GLP-1RA-associated facial and cervical change appears to represent a distinct phenotype characterized by rapid superficial fat deflation, relative structural unmasking, dermal compromise, and potential lean mass loss. The proposed Fat, Architecture, and Cervical Evaluation (FACE) framework organizes preoperative assessment into three graded domains: Fat, Architecture, and Cervical. Relative domain patterns classify patients into deflation-dominant, mixed, and support-dominant phenotypes, linking morphology to treatment strategies ranging from targeted volume restoration to combining fat grafting with formal face and neck lifting.
Conclusions
GLP-1RA-associated facial and cervical change requires an anatomy-driven approach that distinguishes reversible deflation from true structural descent. The FACE framework is proposed as a conceptual and educational tool to standardize assessment, guide individualized treatment selection, and support future validation in this expanding patient population.