When 29-year-old Maria, a social media executive from New York, arrived for a routine Botox appointment, she was surprised by an elective add-on her doctor proffered: Ozempic.

“[My doctor] said, ‘Oh, do you want a shot of Ozempic while you’re here?’ like she was offering me an extra napkin or something.” On hearing she could lose up to fifteen pounds that week, Maria took it, later finding the subsequent nausea overwhelming. But on the Upper East Side, where she had her shot, and across the nation, more and more people are collecting a weekly prescription — covertly or not.

In the blink of an eye, Ozempic, otherwise known as semaglutide, and its competitors like Wegovy and Rybelsus went from a little-known medicine for diabetics to a cultural touchstone. Its off-label use for weight loss, and fast, is what catapulted the drug from pharmaceutical-rep chatter to the preserve of Hollywood starlets, socialites and elite zip codes.

The drug’s prevalence has led to less consumption of candy and beer, per Walmart, and the rise of Ozempic face, a “suddenly gaunt, hollow-looking … prematurely aged face,” leading clients to change their minds on once-undesirable roundness and plumpness, said Dr. Ahmed El Muntasar, a general and aesthetic practitioner in the UK.

Moreover, Ozempic’s rise has yielded a hit on the “snatched” look. Spate, a consumer trends platform, found that social media searches for “contouring” are down 10.6 percent year-on-year, with co-founder Yarden Horwitz adding that while contouring techniques are slowing down in search, bronzing products, which create more of a healthy all-over glow, are up 33 percent since last year.

Skin-tightening lasers like Morpheus8, which can cost around $1,700 for a single face-and-neck session, and microdroplet treatments like Profhilo and the newly-FDA approved Skinvive that improve skin hydration the fine lines caused by sagging skin are also trending, experts said. Microdroplet treatments can cost upwards of $500 in prestige clinics.

“In my practice, I see a lot of people who didn’t need any facial filler because they were heavier people,” said Dr. Corey L. Hartman, a board-certified dermatologist with an aesthetic practice in Birmingham, Alabama. Now, those same patients are starting to request volumising treatments to replenish what Ozempic has taken away.

Plump It Up

The idea of roundness as desirable is an about-face from the contouring era that’s persisted since the mid 2010s, where sculpting ruled supreme. Popularised by social media influencers and celebrities, contouring accentuates shadow and definition, giving the face a sculpted look. In its heyday, cosmetics brands like Anastasia Beverly Hills and Fenty Beauty rushed to add sculpting sticks, palettes and kits to their line-up. In 2022, the craze went even further, with a procedure known as buccal fat removal, which can cost around $9,500, becoming popularised. A permanent, surgical procedure, it slims down the fat pads in the cheeks for more angular appearance.

But now some of those same patients are looking to be re-plumped. The likes of Dr. Hartman and Dr. El Muntasar can offer a range of procedures, including injectable dermal fillers composed of hyaluronic acid to give instant volume or bio-stimulating injections such as Sculptra, which can cost upwards of $1,000 per syringe, that help the skin produce more collagen to replenish what’s lost.

Dr. Hartman noted interest in Sculptra in his clinic is up threefold this year alone. Lisa Goodman, founder and chief of the bicoastal Goodskin Clinics pointed to the rising popularity of a treatment called Renuva — around $1,800 per syringe in some clinics — that stimulates the production of fat. Goodman said that clients view it as more holistic, or less fake, “because it stimulates your own fat cells, rather than just filling with pure volume.”

For Dr. Robert Schwarcz, an oculofacial plastic surgeon based in New York’s well-heeled Upper East Side, Ozempic has meant a change to an old faithful: the facelift. For a facelift to look natural, there still needs to be a good amount of volume under the skin to play around with. “Oftentimes, [patients] now just don’t have enough fat on their face,” he said. Instead, he has to harvest the fullness from other parts of the body via a fat graft.

The volumisation side of Dr. Schwarcz’s practice has expanded 25 percent, including client requests for fillers and fat grafting.

The Investment Opportunity

Aesthetics clinics and medical spas are in a strong position to capture residuals from the Ozempic boom. Research from consulting group McKinsey & Co. indicates that the US beauty services sector is expected to grow by 7 percent per year up to 2027, nearing $80 billion as a sector.

With a flood of new Ozempic patients looking for the next facial filler, clinics are expected to become more attractive investment targets. Just last year private equity juggernaut KKR took a minority stake in SkinSpirit, a US chain specialising in injectables.

Investors favour aesthetics practices due to their relatively straightforward financial modelling. Once a business has a certain number of units open, it’s easy to predict how many more can be opened in five years, providing the clinic concept is proven. What’s more, consumers show no signs of cutting back — partly because they can’t self-administer fillers like they might DIY a manicure, but also because it’s become normalised. A 2022 audit by the British Association of Aesthetic Plastic Surgeons (BAAPs) showed a 124 percent increase in Botox treatments against the previous year.

Dr. Hartman added that for the best results, bio-stimulating treatments require a few sessions, spaced apart. That’s more chargeable chair time for the proprietor.

There’s also the fact that one change often begets another. “[Patients] often come in towards the middle of their weight loss. And they say, ‘How do I make my face match my body?” said Goodman.

Maria’s name has been changed to protect her identity.