Objectives: To evaluate the clinical and ultrasound response patterns of a patient treated with HIFU who presented facial sagging under treatment with GLP-1 agonists.
Introduction: New therapies for diabetes mellitus with glucagon-like peptide-1 (GLP-1) agonists have revolutionised the treatment of obesity by achieving very significant weight loss. On the other hand, rapid loss of bodyweight may lead to a dramatically change in facial features, associated with loss of volume and increased face sagging, which has been called “Ozempic face”.
Many aesthetic therapies have been used for treatment of skin sagging and volume replacement. However, these treatments have not been standardised with objective diagnostic technique that allow quantifying the response of patients.
Materials / method: At baseline and 3-months post treatment, standardised frontal and lateral photographs were performed. Patient was scanned with ultra-high frequency ultrasound (US) linear probes in 24 MHz (GE, Logiq E10) to measure dermal, subcutaneous cellular tissue and SMAS thickness. Shear Wave elastography was carried out to quantify tissue elasticity in kPA and cm/s. After 3 months, US was performed in the same locations.
The patient was treated with HIFU (Liftera, Astherasys Co., Seoul, Republic of Korea) according to the protocol, with linear and pen transducers of 4.5mm, 3.0mm and 1.5mm depths.
Results: We present a 70-year-old woman, with personal history of type II diabetes mellitus, obesity grade II and non-smoker, who was receiving weekly subcutaneous GLP-1 agonist for the last 12 months, resulting in a total loss of 36 kg. Patient had no previous aesthetic treatments.
Comparing skin US findings before and 3 months after HIFU treatment it was noticed a subepidermal low echogenic band (SLEB) attenuation, thinning and organisation of TCS into parallel bundles, better definition of skin bands and horizontalization and better definition of SMAS.
Conclusion: Rapid loss of bodyweight can lead to facial sagging that can be successfully treated with HIFU. Our present case demonstrates US and elastography skin changes in 3 months that clinically represents a significant decrease in skin sagging.
Disclosures
Did you receive any funding to support your research for this TOPIC?
Yes
Please specify entities (individual, company, society): Asterasys has provided the equipment Liftera to perform the patient treatment. General Eletric has provided the ultrasound equipment to evaluate patient before and after treatment.
Were you provided with any honoraria, payment or other compensation for your work on this study?
No
Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No
Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No
This work is presented thanks to the support of: This lecture has received support from an educational grant provided by Asterasys®