Olivia Falcon Explains How to Treat ‘Ozempic Face,’ Hollow Eyes and Sagging Cheeks

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My first glimpse of ‘Ozempic face’ came as a shock. A friend sent me a photograph on WhatsApp after a party we had both attended.

In the picture, I was smiling broadly and looked slimmer than I had for years. But then I noticed something that stopped me in my tracks.

What were those odd, sausage-like pouches beneath my eyes? My neck had changed too, appearing loose, lined and noticeably crepey.

Actress Catherine Deneuve once observed that a woman eventually has to decide whether she wants to preserve her face or her figure.

I wanted both. Like many women, I had become increasingly aware of weight settling around my middle and decided to tackle it with weight-loss injections. The pounds came off, but the change seemed to show most clearly in my face.

That is why reports earlier this month about a new treatment for sagging linked to rapid weight loss immediately caught my attention. Croda, the British chemicals company founded 100 years ago, has repurposed an existing skin-plumping ingredient for what is now commonly called Ozempic face.

The ingredient, Volufiline, is derived from the root of the Chinese plant anemarrhena. It had previously appeared in body creams, although it attracted little commercial interest. Beauty experts are now focusing on its potential to soften the hollow, gaunt appearance that can follow significant weight loss.

Volufiline has since become a social media favourite, with TikTok users calling it a skincare ‘it’ ingredient. The Ordinary introduced the first widely available High Street serum containing it this year, while French and Korean beauty brands are rushing to develop their own formulas. Croda’s share price, which had struggled earlier in the year, has also climbed sharply.

I only wish I had discovered it in 2023, when I received my first Ozempic prescription.

It was not a decision I made casually. By April of that year, weighing a little over 11st, I felt increasingly unwell. At 48, I was perimenopausal, constantly bloated and approaching a size 14, despite having worn a size 10 for most of my adult life.

My main worry was my health rather than my reflection. I was suffering from severe lower-back pain, while blood tests showed prediabetes and high cholesterol: my cholesterol reading was 6.6, compared with NHS guidance that it should be below 5. I had two daughters, then aged 11 and 12, and did not want to enter middle age feeling exhausted and prematurely old.

The weight gain had affected my self-esteem as well. Fashion has always been central to my life: I spent four years at Vogue as assistant to then-editor Alexandra Shulman before becoming beauty editor at Tatler.

Looking healthy and well dressed had always felt like part of my professional identity. Yet instead of reaching for my favourite structured Roland Mouret dresses and tailored trousers, I was hiding in loose Zara frocks. I wanted to recognise myself again.

For six months, I tried to avoid weight-loss injections. I took supplements, exercised more and consulted a nutritionist. But any weight lost through turning down pasta and working harder at the gym returned as soon as my willpower faltered.

Eventually, I arranged a medical consultation with private doctor Wendy Denning at the Health Doctors practice on Devonshire Place in central London. She carried out a thorough assessment, including blood tests, a thyroid examination, a BMI check and an extensive review of my medical history, before prescribing Ozempic.

At that stage, weight-loss injections were still relatively new and I knew only a few people using them. I was nervous, particularly because I usually prefer to endure a headache rather than take a paracetamol. But I trusted Wendy and started on 0.25mg before increasing to 0.5mg after four months.

Taking the medication gradually meant I avoided the nausea and constipation often associated with it. Over six months, I lost 7kg — slightly more than a stone — and finally shifted the weight that had proved so difficult to lose.

I also saw significant changes in my face. Despite my burgeoning midlife weight gain, I’ve always had quite a long, thin face and I suspect the changes showed up sooner on me than they would on more round-faced women.

There wasn’t much spare fat to lose, and it didn’t take long for definition to tip into depletion. Dermatologist Dr Lindsey Bordone puts it plainly: ‘Anyone who loses weight quickly notices changes in their face.’

Loss of fullness can leave skin looking looser and lines more apparent. Midlife skin is also part of ageing, of course – the medication isn’t necessarily responsible for every change, but it definitely doesn’t help.

I was confident that my face wasn’t sagging enough to merit surgery, but my under-eye problem needed a full examination.

About a week after sausage-gate, I saw Dr Munir Somji at his Dr MediSpa clinic in Knightsbridge. He examined the area with a handheld ultrasound device and identified the problem.

With weight loss, the fat pads under my eyes had diminished, which then allowed old under-eye filler – which I’d had injected five years before – to shift and migrate down my face.

In fact, it’s a well-documented phenomenon: when facial fat shrinks away, you remove the cushioning and camouflage around facial filler and get weird, conspicuous rolls and bumps.

Dr Somji’s solution was to dissolve them using hyaluronidase, an enzyme that breaks down the hyaluronic acid in filler. I noticed an immediate improvement as the sausages flattened.

But then there was my neck. The neck is often described as ground zero for ageing because the skin is thinner than in many other areas of the face, and I was a textbook example of Ozempic-induced scrawniness.

As the founder of The Editor’s List, a cosmetic concierge service that directs my clients to the best cosmetic doctors and surgeons in the world, I’m lucky to be able to access expert advice.

It was the brilliant Dr Paris Acharya, who has a light hand and a very good eye, who told me about an injectable treatment known as a Radiesse wash. Radiesse is a gel filler containing tiny calcium hydroxylapatite particles – a mineral found in bone and often used in dentistry.

Used in a highly diluted form and distributed beneath the skin with a cannula, it’s intended to stimulate collagen and improve skin quality rather than simply deliver bulk. I like to think of it as encouraging the creation of fresh scaffolding beneath thinning skin.

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I felt I could see a difference after one treatment (which was fortunate considering that it costs about £500 a session), although collagen rebuilding takes at least six weeks.

Treatment courses and longevity vary – two sessions about six weeks apart are often recommended, with benefits lasting roughly 18 months.

I had my treatment about 14 months ago and have been very happy with the result, although recently the crepiness has started to return. To maintain my results and keep my neck looking less straggly, I recently tried the treatment XERF – beloved of Kim Kardashian – with Dr Nyla Raja at her clinic in Mayfair, west London.

This radiofrequency device, which arrived in UK clinics last month, works by delivering controlled heat beneath the skin. The claim is that it encourages collagen remodelling and improves firmness, which is helpful for anyone showing the early signs of saggy jowls.

The real changes I noticed, however, were again on my neck, where it worked a bit like an iron on the crinkly skin, and around my eyes, where it smoothed my crow’s feet.

Keen to solve this problem too, I have also been having Profhilo Structura with Dr Acharya around my mid-face and towards my temples. This hyaluronic-acid injectable targets the superficial fat layer, supposedly supporting and remodelling adipose tissue that can diminish with ageing and weight loss.

For someone with a naturally slim face who was becoming a little hollow around my temples and mid-face, it has helped fill it out in a fresh, natural way.

Since spring 2024, after my weight plateaued, I switched from Ozempic to Mounjaro, taking 2.5mg every 12 days, which has worked well to keep me at a healthy weight.

Now, I’m back in a size 10. I remain on a 2.5mg dose of Mounjaro under medical supervision, with regular blood tests.

I’m planning to continue for now, despite the fact none of us knows or understands the long-term effects of taking weight-loss drugs yet. I also eat well, with smaller portions, no snacking and a decent serving of protein at every meal, plus lots of fruit and vegetables.

For me, Ozempic and now Mounjaro has been genuinely life-enhancing and improved my health. But I’ve also learnt that losing weight comes with compromises.

At 52, I’m not trying to look 22 but I simply want my face to reflect out how healthy and energised I feel.

What I’ve discovered is that a few carefully considered cosmetic interventions can make all the difference. 

Follow Olivia on Instagram @theeditorslist

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