Originalie
Ilja L. Kruglikov
Partielle faziale Lipodystrophie nach Anwendung der Glukagon-Like Peptid 1-Rezeptoragonisten – eine neue Herausforderung für die ästhetische Medizin
Glucagon-Like Peptide 1 Receptor Agonist-Induced Partial Facial Lipodystrophy – A New Challenge in Aesthetic Medicine
Keywords | Summary | Correspondence | Literature
Keywords
caveolin-1, GLP-1 receptor agonists, local facial lipodystrophy, prevention, treatment
Schlüsselworte
Behandlung, Caveolin-1, GLP-1-Receptoragonist, locale Lipodystrophie, Prävention
Summary
The emergence of a distinct facial appearance characterized by pronounced hollowing of the cheeks, temples chin and periorbital region has become a noteworthy side effect of treatment of obese patients with glucagon-like peptide 1 receptor agonists (GLP-1RAs). This phenomenon presents a quickly growing concern in both dermatology and aesthetic medicine. The reduction of facial adipose tissue in patients receiving GLP-1RAs strongly exceeds the overall weight and fat loss typically associated with these agents, suggesting that the effect cannot be fully attributed to systemic metabolic changes alone. Instead, it raises the possibility of localized, tissue-specific mechanisms of GLP-1RA action within facial fat depots. In this article, we explore the underlying pathophysiology of this selective facial fat loss and propose a new strategy for mitigating or reversing the aesthetic impact of GLP-1RAs.
Zusammenfassung
Das Auftreten der partiellen fazialen Lipodystrophie mit charakteristischen Gesichtsveränderung wie ausgeprägtes eingefallenes Aussehen der Wangen, Schläfen, des Kinns und der Augenpartie, ist eine beachtenswerte Nebenwirkung der Behandlung der übergewichtigen Patienten mit GLP-1-Rezeptoragonisten (GLP-1RA). Dieses Phänomen gibt zunehmend Anlass zur Sorge in der Dermatologie und ästhetischen Medizin. Die Reduktion des Gesichtsfettgewebes bei Patienten die GLP-1RA anwenden übersteigt deutlich den üblicherweise mit diesen Substanzen verbundenen allgemeinen Gewichts- und Fettverlust. Dies deutet darauf hin, dass der Effekt nicht allein auf systemische Stoffwechselveränderungen zurückgeführt werden kann. Vielmehr legt es die Vermutung nahe, dass GLP-1RA lokal und gewebespezifisch in den Gesichtsfettdepots wirken. In diesem Artikel untersuchen wir die zugrunde liegende Pathophysiologie dieses selektiven Gesichtsfettverlusts und bieten eine mögliche Strategie zur Milderung oder Umkehrung der ästhetischen Auswirkungen von GLP-1RA an.
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Korrespondenz-Adresse
Dr. rer. nat. habil. Ilja L. Kruglikov
Wellcomet GmbH, Karlsruhe
Am Mantel 4A
DE-76646 Bruchsal
i.kruglikov@wellcomet.de
Conflict of Interests
Dr. I. Kruglikov ist der geschäftsführende Gesellschafter der Firma Wellcomet GmbH. Wellcomet GmbH hat die Vorbereitung von diesem Artikel nicht beeinflusst.
Literatur
1. Zheng Z, Zong Y, Ma Y, et al. Glucagon-like peptide-1 receptor: mechanisms and advances in therapy, Signal Trans Target Ther. 2024, 9(1): 234.
2. Wirth PJ, Shaffrey SC, Bay C, Rao VK. Current weight loss medications: what plastic surgeons should know. Aesth Surg J. 2024, 44(2): NP177-NP183.
3. Jafar AB, Jacob J, Kao WK, T. Ho T. Soft tissue facial changes following massive weight loss secondary to medical and surgical bariatric interventions: A systematic review”, Aesth Surg J Open Forum. 2024, 6: ojae069.
4. Anyiam O, Phillips B, Quinn K, et al. Metabolic effects of very-low calorie diet, Semaglutide, or combination of the two, in individuals with type 2 diabetes mellitus. Clin Nutr. 2024, 43(8): 1907-1913.
5. Kruglikov IL. Mechanisms of glucagon-like peptide 1 receptor agonist induced facial lipodystrophy and a path toward prevention. J Cosmet Dermatol. Doi: .
6. Liu F, Yang Q, Zhang H, et al. The effects of glucagon-like peptide-1 receptor agonists on adipose tissues in patients with type 2 diabetes: A meta-analysis of randomised controlled trials. PLoS One. 2022, 17(7): e0270899.
7. Iacobellis G, Camarena V, Sant DW, Wang G. Human epicardial fat expresses glucagon-like peptide 1 and 2 receptors genes. Hormone Metab Res. 2017, 49(8): 625-630.
8. Iacobellis G, Mohseni M, Bianco SD, Banga PK. Liraglutide causes large and rapid epicardial fat reduction. Obesity. 2017, 25(2): 311-316.
9. Levine JA, Ray A, Jensen MD. Relation between chubby cheeks and visceral fat. New Eng J Med. 1998, 339(26): 1946-1947.
10. Qa’aty N, Wang Y, Wang A, et al. The antidiabetic hormone glucagon-like peptide-1 induces formation of new elastic fibers in human cardiac fibroblasts after cross-activation of IGF-IR. Endocrinology. 2015, 156(1): 90-102.
11. Kruglikov IL. Entdeckung der Zelltransformationen in der Haut markiert den Beginn einer neuen Ära in der Dermatologie und Ästhetischen Medizin. Kosmet Med. 2020, 41(2): 20-24.
12. Riley N, Kasza I, Hermsmeyer ID, et al. Dietary lipid is largely deposited in skin and rapidly affects insulating properties. Nat Comm. 2025, 16: 4570.
13. Kruglikov IL, Scherer PE. Skin aging as a mechanical phenomenon: The main weak links. Nutr Health Aging. 2018, 4(4): 291-307.
14. Sataray-Rodriguez A, Pham D, Severini C, et al. Investigating the impact of GLP-1 receptor agonist-induced fat loss on collagen synthesis and skin elasticity. J Biomed Sci Eng. 2025, 18(3): 45-59.
15. Rocha RI, Junior WC, Modolin ML, et al. Skin changes due to massive weight loss: histological changes and the causes of the limited results of contouring surgeries. Obes Surg. 2021, 31(4): 1505-1513.
16. Kruglikov IL, Scherer PE. Caveolin-1 as a pathophysiological factor and target in psoriasis. NPJ Aging Mech Dis. 2019, 5(1): 4.
17. Lin DA, Abujamra BA, Revah S, et al. Downregulation of caveolae-associated proteins in psoriasis: A case series study. JID Innov. 2024, 4(2): 100265.
18. Kruglikov IL, Scherer PE. Caveolin-1 as a target in prevention and treatment of hypertrophic scarring. NPJ Regen Med. 2019, 4(1): 9.
19. Jozic I, Sawaya AP, Pastar I, et al. Pharmacological and genetic inhibition of caveolin-1 promotes epithelialization and wound closure. Mol Ther. 2019, 27(11): 1992-2004.
20. Jozic I, Abujamra BA, Elliott MH, et al. Glucocorticoid-mediated induction of caveolin-1 disrupts cytoskeletal organization, inhibits cell migration and re-epithelialization of non-healing wounds. Comm Biol. 2021, 4(1): 757.
21. Kruglikov IL, Zhang Z, Scherer PE. Caveolin-1 in skin aging - from innocent bystander to major contributor. Ageing Res Rev. 2019, 55: 100959.
22. Kruglikov IL, Scherer PE. Caveolin as a universal target in dermatology. Int J Mol Sci. 2019, 21(1): 80.
23. Egger AN, Rajabi‐Estarabadi A, Williams NM, et al. The importance of caveolins and caveolae to dermatology: Lessons from the caves and beyond. Exp. Dermatol. 2020, 29(2): 136-148.
24. Kruglikov IL, Scherer PE. Regulation of the terminal complement cascade in adipose tissue for control of its volume, cellularity and fibrosis. Obesity. 2025, 33: 839-850.
25. Kruglikov IL, Scherer PE. Control of adipose tissue cellularity by the terminal complement cascade”, Nat Rev Endocrinol. 2023, 19(12): 679-680.
26. Montecinos K, Kania B, Goldberg DJ. Semaglutide “Ozempic” face and implications in cosmetic dermatology. Dermatol Rev. 2024, 5(5): e70003.
27. Chervinskaya IG, Kuprina NI, Kruglikov IL. A retrospective pragmatic longitudinal case-series clinical study to evaluate the clinical outcome of triple-frequency ultrasound in treatment of cellulite. Clin Cosmet Invest Dermatol. 2024, 17: 2779-2794.
28. Ahn TH, Lee JS, Kim SY, et al. Application of dual‐frequency ultrasound for reduction of perilesional edema and ecchymosis after rhinoseptoplasty. J Cosmet Dermatol. 2024, 23(3): 830-838.
29. Chervinskaya IG, Gaidash NV, Kruglikov IL. A retrospective pragmatic two‐center clinical study to evaluate the clinical outcome of triple‐frequency ultrasound in the treatment of mild‐to‐severe acne vulgaris. J Cosmet Dermatol. 2025, 24(2): e16672.
