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Joan Rivers would have loved Ozempic, according to her daughter, Melissa Rivers. Melissa would know — she’s been on a GLP-1 herself.
After realizing her metabolism had slowed during menopause, the 58-year-old TV correspondent went on Mounjaro and lost 25 pounds over six months, she revealed to The Post.
“Everything that used to work wasn’t working any longer,” she said.
But there was one downside: She suddenly experienced temporal hollowing, also known as temporal wasting, in which rapid weight loss leads to a loss of volume in the temples, potentially aging the face.
“I always had a close eye on my temples, even before the weight loss, because I’m narrow in that area naturally … but it just became a bigger issue afterwards,” Rivers said.
To save face — literally — she turned to Lisa Goodman, a pioneer in regenerative aesthetics and the founder of GoodSkin Clinics, to add volume back with NuvaSculpt and Xerf. The former combines localized fat growth with tightening and firming, while the latter uses radiofrequency for skin-tightening and lifting.
“It’s about having a soft touch; nothing was ever dramatic,” Rivers explained. “It was literally progressive, and I became a laser junkie — it’s become a sickness.”
“It made a world of difference,” she added.
Transforming from a raisin back into a grape
Rivers is far from the first person to find that weight loss success on a GLP-1 drug can also be aging — and she’s certainly not the only one getting procedures to fix it. Some are even fully going under the knife.
“Temporal hollowing is part of the aging process — fat atrophies as we get older,” explained Dr. Anthony Berlet, founder of Berlet Plastic Surgery in NYC and New Jersey. “But when you’re on a GLP-1 like Ozempic and losing a lot of weight suddenly, the loss of facial fat can make you appear to age prematurely, and we have to put volume back where it’s supposed to be.”
After losing 50 pounds over the course of six months on Ozempic, 33-year-old Veruzka Scavo Krause — who was Miss South America at the World Next Top Model pageant in 2012, Miss Tourism Venezuela 2015 and Miss Europe Spain of 2015 — was ready to reverse her face’s new “hollowed-out” fate.
“I always felt a pressure to keep up with the standards of beauty, especially between the proper weight and measurements,” she said.
“It’s a crazy feeling when you start gaining weight and don’t even recognize yourself anymore, but now I feel like I look back to my early 20s again,” she added.
Considering her young age, Scavo Krause’s plastic surgeon, New York-based Dr. Spero Theodorou, was surprised at the level of laxity in her skin from being on the GLP-1, prompting him to perform a fat grafting technique which involved harvesting her own fat from her waist, or flanks, and injecting it into her temples.
“Once you lose over ten pounds, it really starts showing in your face,” Dr. Theodorou, founder of Theodorou Plastic Surgery and Park Avenue Smart Lipo, explained. “It’s not even so much about the number, but rather how fast you lose it.”
The treatments he uses to “reset” the face make it rounder and not as hollow-looking by targeting the skin and the muscle.
“The sagginess is completely gone,” added Scavo Krause, who also tightened her jowls with liposuction.
While some techniques to battle temporal hollowing involve hyaluronic acid fillers or lactic acid injectables, Dr. Theodorou prefers injecting a patient’s own fat over a foreign body.
Dr. Berlet agrees that fat grafting “is really my best tool for combating that very scary, skeletal look that temporal hollowing creates.”
As temporal hollowing can create visible depressions on the sides of the forehead, he sometimes also performs a lateral brow lift, creating a smoother transition from the outer eyelid and brow into the temples.
Another tempting reason to undergo a fat grafting procedure, which typically takes about half an hour and can be done under local anesthesia, is that it can offer plumping.
“After becoming a raisin on a GLP-1, you can transform back into a grape,” said Berlet.
While it offers natural-looking results, Berlet noted that fat grafting does have some potential drawbacks, including occasional lumpiness or unevenness.
“It’s a bit of an art, but reaching the ultimate goal is easier when using micro fat,” he said.
Patients who have lost substantial weight also have to contend with the possibility that there is limited fat available for harvesting. When it’s scarce, Berlet typically turns to the inner thighs, which are “pretty reliable” sources.
Slimming down and aging backwards
Diane Petrowsky lost a whopping 134 pounds — 70 the old-fashioned way, and the remaining 64 with Ozempic. But after the serious slimdown, she hated how she looked.
“I know I’m aging because I’m 63, but with the hollowness in my face after weight loss, I found myself very ugly,” said Petrowsky, a New Jersey resident who works in education counseling.
To restore the lost volume, she saw Dr. Berlet for fat grafting, including around her temples. She also got a face and neck lift, a lip lift, and surgery on her upper and lower eyelids.
“Since the fat already contains your own regenerative cells, including stem cells, it may also help improve skin quality in addition to restoring lost volume, making the eyes and skin look younger and healthier,” Berlet said.
Petrowsky is happy with the results: “I got a glow.”
“When I wake up in the morning and look in the mirror, I realize how much this has changed my life, especially with how it refines your face,” she said.
She eventually wants a breast lift as “gravity has taken a hold with the weight loss,” but for right now, she is just glad to be “feeling back to herself” and not having to “hide” when she goes out.
“I used to wear big clothes and hoodies and now I wear bright colors,” she said.
A booming business
Both surgeons agree that they are busier these days due to the popularity of Ozempic.
“Losing fat in the face can dramatically affect your appearance, no matter how much weight
you’ve lost overall,” said Theodorou.
But he notes that it’s not a good idea to rush into nip/tucks post-slimdown. Instead, he suggests giving yourself a good six months after starting a GLP-1 to give everything a chance to settle before deciding on any particular procedures to correct hollowing or sagging skin.
