Aesthetic Surgery After Massive Weight Loss: Facial Plastic Surgery Team Recognized by ASJ for Best Research Paper
An article on soft-tissue facial changes after massive weight loss following medical or surgical intervention was recognized by Aesthetic Surgery Journal Open Forum as the publication’s Best Research Paper.
Its authors, who were commended by the ASJ editorial board for their contribution to clinical knowledge and practice, are Tang Ho, MD, director of the Texas Center for Facial Plastic Surgery and an associate professor of otorhinolaryngology at McGovern Medical School at UTHealth Houston; Katherine Kao, MD, assistant professor of otorhinolaryngology at the medical school; Ali Jafar, MD, a former fellow in the department who now is an assistant professor of otolaryngology and chief of the Division of Rhinology and Facial Plastic Surgery at Kuwait University; and Jerril Jacob, a fourth-year medical student. They were formally recognized at The Aesthetic MEET 2025 held in March in Austin, Texas.
“People who take weight-loss drugs or undergo bariatric surgery to enhance their overall health discover that massive weight loss contributes to the appearance of aging,” says Dr. Jafar, who came up with the idea for the study, contributed substantially to the research, and wrote the manuscript. “Our goal was to analyze the literature with a focus on facial aging, perceived attractiveness, and considerations for facial rejuvenation. We believe ours is the first systematic review focused on soft tissue changes in people with massive weight loss that also compares medical treatment and bariatric surgery.”
Dr. Jafar grew interested in the topic during his time as a facial plastic surgery fellow after discovering that surgery on patients with massive weight loss “is complex. Traditionally, people who undergo facelift are in their 50s, 60s, or 70s, but the population that undergoes surgical or medical weight loss tends to be younger,” he says. “They lose tissue volume in the mid-cheek region and nasal labial folds, but they generally have better underlying bone structure, good skin texture and turgidity, and strong ligaments. So, the question is do we recommend fillers or fat implants rather than the traditional deep plane facelift? To correct the significant neck skin laxity that accompanies weight loss, surgery is the only option.”
Bariatric surgery has a profound impact on regional facial fat loss. The researchers also noted that people who take Ozempic® or other metabolic drugs experience muscle loss in the face and body, in addition to fat loss, leading to a phenomenon noted in the facial plastic surgery literature as “Ozempic faces.”
In addition to treatment considerations, Dr. Jafar notes that younger weight-loss patients have higher expectations of the aesthetic results of treatment and may need greater management of expectations. “Treatment requires robust counseling related to patient expectations, including discussion of all options,” he says.
During the systematic literature review, the researchers discovered that very little had been published on the topic. The review was conducted from 2005 through February 10, 2024, using electronic databases. Most published studies were conducted in the U.S. and Europe, with a minority in South America and Australia.
“The study findings are quite relevant to the clinical practice of facial plastic surgery, especially now,” Dr. Ho notes. “Further quantitative volumetric facial analysis of soft tissue changes after bariatric treatment would yield valuable results. This is especially pertinent considering the increasing use of weight-loss medications.”
Reference
Jafar AB, Jacob J, Kao WK, Ho T. Soft Tissue Facial Changes Following Massive Weight Loss Secondary to Medical and Surgical Bariatric Interventions: A Systematic Review. Aesthetic Surgery Journal Open Forum. 2024 Aug 22:6:ojae069. doi: 10.1093/asjof/ojae069.eCollection 2024.