Anna Petropoulos, MD, FRCS

Hello and thank you for your question! At 43 and in the middle of weight loss, it’s totally normal to worry about loose skin — and you do have safe options! -Microneedling (no RF): Safe for all skin tones, no light/heat, improves texture and firmness. -RF Microneedling (e.g., Morpheus8): Possible with caution — your ankle metal likely won’t interfere, but a provider should screen you carefully. -Topicals & supplements: Retinol-based firming creams and collagen peptides can help improve skin tone gradually. -Massage & lymphatic drainage: Gentle, natural ways to improve skin appearance and support circulation. -Surgery (if needed): A tummy tuck is an option for more significant laxity post-weight loss. Avoid for now: -Lasers, IPL, and light-based devices (due to photosensitive meds and risk of hyperpigmentation). You’ll get the best results with a provider experienced in treating skin of color and sensitive cases. Best of luck in your journey! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA

Hello and thank you for your great question! At 33, it’s common to start noticing changes like marionette lines, lower face volume loss, and early jowling. Based on the history you have provided, we’d likely want to focus on longer-lasting or regenerative options. Biostimulators like Sculptra or Radiesse can stimulate collagen production for more structural support and subtle volume improvement that lasts longer than traditional filler. Thread lifts (especially around the marionette and pre-jowl area) can help reposition tissue and soften early sagging. Microneedling with RF (like Morpheus8, SylfirmX) can tighten skin and improve texture in the lower face with minimal downtime. Fat transfer may be an option if you're looking for something permanent and are open to a surgical route. Best results often come from combining treatments—especially when fillers alone aren’t giving you the longevity or lift you're after. Best of luck in your journey! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA

Hello and thank you for your question! Yes, you can likely have Thermage with cheek Gore-Tex implants, but there are some precautions to consider. Gore-Tex is non-metallic and doesn’t conduct heat, so it’s generally safer than metal implants when using radiofrequency. However, Thermage does deliver heat to deeper skin layers, and this could potentially cause localized swelling, discomfort, or tissue tightening around the implant, which may slightly affect its position if not securely placed. You’re likely a good candidate if: -Your implants are well-healed, stable, and placed deep enough. -You haven’t had issues like shifting, inflammation, or visible edges. -Your provider is experienced and avoids aggressive passes directly over the implants. It’s best to consult both your aesthetic provider and, if possible, the surgeon who placed the implants to ensure personalized safety. Best of luck! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA

Hello and thank you for your question. "Ozempic face" refers to facial fat loss, often due to weight loss on semaglutide. However, even with minimal weight loss (like your 5 lbs), some patients experience disproportionate facial volume loss, likely due to individual fat distribution or sensitivity. A facelift will tighten and lift tissue, but it won’t prevent further volume loss if the underlying cause (Ozempic) continues. So yes—resuming Ozempic after a facelift could lead to recurrence of facial hollowing. If you're not getting significant glycemic or weight benefit from Ozempic, and cosmetic effects are concerning, it’s reasonable to consider switching to another diabetes medication. Options include: Dulaglutide (Trulicity) – another GLP-1 with less facial fat loss reported SGLT2 inhibitors (e.g., Jardiance) – weight-neutral or mild loss DPP-4 inhibitors (e.g., Januvia) – weight-neutral Discuss this with an endocrinologist and, if planning surgery, a facial plastic surgeon familiar with GLP-1 effects. From the non-surgical perspective, treatments like RF-microneedling and Sculptra can combat or even prevent some of these Ozempic-related changes- that may be worth looking into! Best of luck! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA

Hello and thank you for your question! Ozempic is the FDA-approved brand-name version of semaglutide, made by Novo Nordisk with strict quality control. Compounded semaglutide is not FDA-approved, but it can be very safe when made by a reputable compounding pharmacy. The key is that your provider does their research—using only trusted, accredited pharmacies that follow high-quality standards. Should you worry? Not if you're under the care of a knowledgeable provider who ensures the compound is the correct form (semaglutide base, not salt) and comes from a certified pharmacy. When done right, many people use compounded semaglutide safely and effectively. If you’re 25 lbs overweight, you may qualify for Wegovy (FDA-approved for weight loss), but compounded versions can be a good alternative when prescribed responsibly. Best of luck! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA