Aesthet Surg J. 2024 Oct 15;44(11):NP809-NP818. doi: 10.1093/asj/sjae132.
Following the advent of glucagon-like peptide-1 receptor agonists (GLP-1RAs), subsequent unintended effects such as accelerated facial aging and altered skin health have been noted. This review delves deeper into the causative underlying mechanisms and provides insights into the intricate relationship between GLP-1RAs, adipose tissue, and premature facial aging, thereby highlighting the need for a nuanced understanding of their effects on facial alterations and skin health. Studies exploring the potential effects of GLP-1RAs on facial alterations and offering insights into the possible underlying mechanisms, causes, and clinical implications were included. The accelerated facial aging and altered skin health observed in GLP-1RA patients appears to be multifactorial, involving loss of dermal and subcutaneous white adipose tissue, and altered proliferation and differentiation of adipose-derived stem cells (ADSCs), and impacts on the production and secretion of hormonal and metabolic factors. These changes compromise the structural integrity and barrier function of the skin and may lead to diminished facial muscle mass, further exacerbating the appearance of aging. The insights presented call for a paradigm shift in the clinical management of facial changes induced by GLP-1RAs, with a focus on treatment strategies aimed at targeting ADSC stimulation. These include autologous fat transfers to reintroduce cells rich in ADSCs for rejuvenation, composite fat grafting combining autologous fat with/without stromal vascular fraction, and the strategic use of soft tissue fillers for volume restoration and biostimulation. This review highlights the potential role of GLP-1RAs in modulating adipose tissue dynamics, thereby contributing to accelerated aging through metabolic, structural, and hormonal pathways.
继胰高血糖素样肽-1 受体激动剂 (GLP-1RAs) 问世以来,人们注意到了一些意想不到的后续影响,如加速面部衰老和改变皮肤健康。本综述深入探讨了潜在的致病机制,并深入了解了 GLP-1RAs、脂肪组织与过早面部衰老之间的复杂关系,从而强调了需要对其对面部改变和皮肤健康的影响有细致的了解。本研究纳入了探讨 GLP-1RAs 对面部改变的潜在影响,并深入了解可能的潜在机制、原因和临床意义的研究。GLP-1RA 患者观察到的加速面部衰老和改变皮肤健康似乎是多因素的,涉及真皮和皮下白色脂肪组织的丢失,以及脂肪来源干细胞 (ADSCs) 的增殖和分化改变,以及对激素和代谢因子的产生和分泌的影响。这些变化损害了皮肤的结构完整性和屏障功能,可能导致面部肌肉质量下降,进一步加剧衰老的外观。提出的见解呼吁对 GLP-1RAs 引起的面部变化的临床管理模式进行转变,重点是针对 ADSC 刺激的治疗策略。这些策略包括自体脂肪转移,以重新引入富含 ADSC 的细胞进行年轻化;复合脂肪移植,将自体脂肪与/或基质血管部分结合;以及有针对性地使用软组织填充剂进行体积恢复和生物刺激。本综述强调了 GLP-1RAs 在调节脂肪组织动力学方面的潜在作用,从而通过代谢、结构和激素途径加速衰老。