Rapid Weight Loss and Changes to the Face

What are the facial changes associated with rapid weight loss?

Rapid weight loss can be associated with changes in facial shape and volume. Many people are pleased with the changes overall. Some people notice increased hollowing, changes in facial contours, reduced skin support or changes in skin quality. These changes vary considerably between individuals and depend on factors such as age, genetics, overall health and the amount and rate of weight loss.

Risk factors distisfaction with their facial changes due weight loss include:

Age >40
Peri or post menopausal
>20% total body weight lost
Rapid weight loss (>10% in <6 months)
Previously thin face

What causes these changes?

Facial changes associated with rapid weight loss usually develop as a result of several factors working together, including:Loss of facial fat, superficial fats pads even more than deep fat pads

• Reduction of stem cells numbers and activity in the fat
• Loss of oestrogen produced in the DWAT fat under the skin
• Reduction in fibroblast activity.
• Individual facial anatomy and genetics.
• The amount and rate of weight loss.
• Loss of collagen and elastin, hyaluronic acid and GAGs in the skin and supporting tissues.
• Changes in skin elasticity.
• Overall health and nutritional status.
• Hollowing of the temples, around the eyes, sides of face
• Jowls may become more obvious with loss of support in other areas of the face.The skin cannot remodel as fast as the fat disappears.
• This differs from ageing in that the bone and ligaments stay the same and more fat is lost from superficial fatrather than the deep fat pads, unless loss is more than 20% of total body weight.

The underlying cause varies from person to person, making an individual assessment an important part of the consultation.

Assessment

During your consultation, we’ll assess your face as a whole, including facial proportions, skin quality, facial volume, supporting tissues and underlying facial anatomy. We’ll also discuss your medical history, weight changes and general health to better understand the factors contributing to your concerns. Understanding the underlying cause helps determine whether management is appropriate for you.

Why assessment is important

Facial changes following rapid weight loss rarely affect just one area of the face. In many people, the temples, cheeks, around the eyes, jawline and skin quality may all change to varying degrees. Individual anatomy, the rate of weight loss and overall skin quality also influence how these changes present. A comprehensive assessment helps identify the factors contributing to your concerns and guides appropriate, individualised management.

Individualised management

During your consultation, we’ll discuss whether management is appropriate for your individual concerns. If so, we’ll explain the available options, together with theexpected benefits, limitations and potential risks, so you can make an informed decision about your care. We recommend slow managed weight loss, and that patients are supervised by their general practitioners.We work with your usual GP when dealing with these concerns.

Prepared by
Dr Simone Doreian
Specialist General Practitioner
AHPRA Registration: MED0001163462