Patients are complaining about 'Ozempic breasts'
Key Takeaways
“Ozempic breasts,” a form of breast ptosis, refers to the deflation of breasts experienced by patients who have undergone rapid and significant weight loss following semaglutide use.
Symptoms of Ozempic breasts include sagging, loss of volume, and tenderness.
Advise patients that such occurrence of breast sagging can be temporary, and often improves once the drug is stopped. Using a low dose of semaglutide, a supportive bra, and doing gentle breast massages can also help.
Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is among the five FDA-approved anti-obesity medications for long-term use. One study reported an average weight loss of 6% by 3 months and 12% by 7 months on semaglutide.[]
Unfortunately for some, the rapid loss of fat throughout the body can result in the reduction of subcutaneous fat in unexpected areas, such as the face, leading to what has been dubbed "Ozempic face" by Dr. Paul Jarrod Frank, a celebrity dermatologist.[]
This phenomenon has now expanded to add terms like "Ozempic butt" and "Ozempic breasts" to the semaglutide lexicon, as reports of less-than-satisfactory fat loss from other parts of the body emerge.
Defining ‘Ozempic breasts’
Semaglutide-induced rapid weight reduction can cause sudden and unexpected changes in breast size and shape, known colloquially as Ozempic breasts.
“Typically, Ozempic breasts mimic postpartum breasts with decreased fullness and increased sag, or ptosis,” board-certified plastic surgeon Aaron Gilson, DO, tells MDLinx. Clinically, breast ptosis is characterized by sagging and shrinking of the breasts, with the nipple descending inferiorly below the breast fold and excess skin in the lower pole of the breast.[]
While anecdotal reports suggest an association between Ozempic use and changes in breast volume, definitive research is currently unavailable.
Adipose tissue reduction
Semaglutide promotes weight loss by enhancing satiety, reducing food cravings, and lowering calorie intake.
This weight loss includes a reduction in adipose tissue, a significant component of breast tissue. Its loss can lead to an empty skin envelope and deflated, downward-pointing breasts. Moreover, the depletion of fatty acids from the skin's surface can disrupt the skin barrier, causing dryness and dullness.
Although specific data on breast adipose tissue loss due to semaglutide is lacking, these effects are similar to those observed after bariatric surgery. Studies on bariatric surgery provide some insight; for example, the Journal of Obesity Surgery reports that women lose an average of 39.4% of their breast volume following major weight loss surgery.[]
According to Dr. Gilson, some groups of patients are at a higher risk of developing Ozempic breasts than others. These include women with larger breasts at baseline, patients with significant weight loss goals, and older patients who typically have less skin elasticity, making changes in breast volume more visible as sagging or ptosis.
Additionally, patients with fibrocystic breasts may notice that benign lumps become more apparent as the surrounding tissue decreases.
In the clinic
It is helpful for your patients to understand that breast sagging is a result of the rapid weight loss associated with semaglutide, not the drug itself. Hence, adopting a gradual weight loss approach with dietary restrictions, along with adequate physical exercise, can mitigate the symptoms.
Dr. Gilson suggests that “targeting and building the pectoralis and chest muscles can help maintain the appearance of some breast volume.”
Additionally, maintaining a high-protein diet from the onset of semaglutide therapy can support muscle mass and body composition, further reducing the risk of sagging breasts.
Encourage patients to wear a supportive bra throughout the day to minimize the stretching of breast ligaments and gravitational sagging. Gentle breast massages can also promote circulation.
An alternative approach could involve the use of low-dose semaglutide. A 2024 cohort study of overweight or obese patients with type 1 diabetes mellitus demonstrated that low-dose semaglutide (0.5 mg per week) led to an average weight reduction of 11% after 6 months of therapy, making it a viable option for gradual weight loss.[]
Furthermore, semaglutide's effects tend to wane after discontinuation, with patients often regaining about two-thirds of their original weight within a year—a phenomenon termed "Ozempic rebound."[]
Breast sagging could be a temporary side effect lasting only while the patient takes the drug. Therefore, patients should be advised to reach and maintain their desired weight for at least a year before considering any breast-related interventions.
For interventional management, refer patients to a qualified plastic surgeon for procedures such as mastopexy, breast augmentation, and lift with implants. Ensure the patient’s weight is stable before they proceed with any surgical intervention to avoid rebound weight gain, and make sure to help them set realistic expectations.
What this means for you
At the end of the day, we must recognize that it is the rapid weight loss associated with semaglutide—not the drug itself—that causes some less-than-savory side effects, such as deflated breasts. Adopting a gradual weight loss approach with the proper dietary measures can mitigate many adverse events linked to semaglutide medications prescribed to promote weight loss.