Aesthetic plastic surgery · 2026
Beyond Weight Loss: Facial Remodeling Associated with GLP-1 Receptor Agonists-A Systematic Review and Therapeutic Framework.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
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Maglitto Fabio, Salzano Giovanni, Trotta Serena, Manzo Eutilia, Vaira Luigi, Petrocelli Marzia, Dell'Aversana Orabona Giovanni
Аннотация
BACKGROUND: Facial volume depletion and skin laxity have increasingly been reported during weight loss associated with glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment. However, these changes are not recognized as a distinct clinical entity and may overlap with those occurring after other forms of rapid or massive weight loss. Evidence regarding their treatment remains limited.
METHODS: This systematic review was conducted according to PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261415797). PubMed/MEDLINE, Embase, and Scopus were searched from inception to June 5, 2026. Clinical studies evaluating interventions for facial changes associated with GLP-1RA-related weight loss were included. Study characteristics, interventions, outcomes, safety, and methodological limitations were synthesized narratively. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools.
RESULTS: Four uncontrolled observational studies involving 98 treated participants met the eligibility criteria. Two studies enrolled exclusively patients receiving GLP-1RAs or related incretin-based medications, whereas two included mixed weight-loss etiologies. Investigated interventions included injectable biostimulators and fillers, endotissutal bipolar radiofrequency, and a topical formulation. All studies reported favorable within-group findings; however, heterogeneous populations, weight-loss trajectories, interventions, outcomes, and follow-up durations, together with the absence of comparator groups, precluded conclusions regarding treatment effectiveness or superiority.
CONCLUSIONS: The available evidence is preliminary and insufficient to support a validated therapeutic algorithm. The proposed framework is hypothesis-generating and integrates limited review findings with established principles of post-weight-loss facial rejuvenation. Comparative studies evaluating surgical and nonsurgical interventions are required.
LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Trial registration number PROSPERO Registration CRD420261415797.
METHODS: This systematic review was conducted according to PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261415797). PubMed/MEDLINE, Embase, and Scopus were searched from inception to June 5, 2026. Clinical studies evaluating interventions for facial changes associated with GLP-1RA-related weight loss were included. Study characteristics, interventions, outcomes, safety, and methodological limitations were synthesized narratively. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools.
RESULTS: Four uncontrolled observational studies involving 98 treated participants met the eligibility criteria. Two studies enrolled exclusively patients receiving GLP-1RAs or related incretin-based medications, whereas two included mixed weight-loss etiologies. Investigated interventions included injectable biostimulators and fillers, endotissutal bipolar radiofrequency, and a topical formulation. All studies reported favorable within-group findings; however, heterogeneous populations, weight-loss trajectories, interventions, outcomes, and follow-up durations, together with the absence of comparator groups, precluded conclusions regarding treatment effectiveness or superiority.
CONCLUSIONS: The available evidence is preliminary and insufficient to support a validated therapeutic algorithm. The proposed framework is hypothesis-generating and integrates limited review findings with established principles of post-weight-loss facial rejuvenation. Comparative studies evaluating surgical and nonsurgical interventions are required.
LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Trial registration number PROSPERO Registration CRD420261415797.