medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-365medsovet-9424Research ArticleКОСМЕТОЛОГИЯCOSMETOLOGYКомплексные протоколы коррекции возрастных изменений, вызванных лекарственно-индуцированной потерей подкожно-жировой клетчатки лица и тела, с помощью препаратов на основе PLAComplex protocols for correction of age-related changes caused by drug-induced loss of subcutaneous fat tissue of the face and body using a PLA-based preparationhttps://orcid.org/0000-0001-8657-9559МоржанаеваМ. А.MorzhanaevaM. A.

Моржанаева Мария Андреевна - к.м.н., врач-косметолог, генетический консультант, ООО «Мелситек», клиника косметологии; ООО «Мелситек», генетическая лаборатория “Melsytech Genetics”.

127473, Москва, 2-й Щемиловский пер., д. 4; 603087, Нижний Новгород, ул. Верхне-Печерская, д. 7д

Maria A. Morzhanaeva - Cand. Sci. (Med.), Cosmetologist, Expert genetic, Melsytech LLC, Cosmetology Clinic; Melsytech LLC, Genetic Laboratory “Melsytech Genetics”.

4, 2nd Shchemilovsky Lane, Moscow, 127473; 7d, Verkhne-Pecherskaya St., Nizhny Novgorod, 603087

maria_morzhanaeva@mail.ruhttps://orcid.org/0000-0002-5885-4872СвечниковаЕ. В.SvechnikovaE. V.

Свечникова Елена Владимировна - д.м.н., заведующая отделением дерматовенерологии и косметологии, Поликлиника №1 Управления делами Президента РФ; профессор кафедры кожных и венерических болезней, Российский биотехнологический университет (РОСБИОТЕХ).

119002, Москва, пер. Сивцев Вражек, д. 26/28; 125080, Москва, Волоколамское шоссе, д. 11

Elena V. Svechnikova - Dr. Sci. (Med.), Head of the Department of Dermatovenereology and Cosmetology, Polyclinic No. 1 of the Administrative Department of the Russian Federation; Professor of the Department of Skin and Venereal Diseases; Russian BU.

26/28, Sivtsev Vrazhek Lane, Moscow, 119002; 11, Volokolamskoe Shosse, Moscow, 125080

elene-elene@bk.ruhttps://orcid.org/0000-0003-0314-7035ГорскаяА. А.GorskayaA. A.

Горская Антонина Александровна - врач-косметолог, руководитель, клиника O’LIVE.

603022, Нижний Новгород, ул. Тимирязева, д. 31а

Antonina A. Gorskaya - Cosmetologist, Head/

31a, Timiryazev St., Nizhny Novgorod, 603022

aa.gorskaya@gmail.comhttps://orcid.org/0000-0002-5619-6757АртемьеваН. О.ArtemyevaN. O.

Артемьева Наталья Олеговна - к.м.н., врач-диетолог, генетик, экспертная многопрофильная клиника «ОМНИУС».

119192, Москва, ул. Мосфильмовская, д. 53

Natalya O. Artemyeva - Cand. Sci. (Med.), Nutritionist, Geneticist, Expert Multidisciplinary Clinic “OMNIUS”.

53, Mosfilmovskaya St., Moscow, 119192

natalya.artemeva.89@mail.ruООО «Мелситек», клиника косметологии; ООО «Мелситек», генетическая лаборатория “Melsytech Genetics”РоссияMelsytech LLC, Cosmetology Clinic; Melsytech LLC, Genetic Laboratory “Melsytech Genetics”Russian FederationПоликлиника №1 Управления делами Президента Российской Федерации; Российский биотехнологический университет (РОСБИОТЕХ)РоссияPolyclinic No. 1 of the Administrative Department of the Russian Federation; Russian Biotechnological UniversityRussian FederationКлиника O’LIVEРоссияO’LIVE ClinicRussian FederationЭкспертная многопрофильная клиника «ОМНИУС»РоссияExpert Multidisciplinary Clinic “OMNIUS”Russian Federation202530092025014202211Copyright © Моржанаева М.А., Свечникова Е.В., Горская А.А., Артемьева Н.О., 20252025Моржанаева М.А., Свечникова Е.В., Горская А.А., Артемьева Н.О.Morzhanaeva M.A., Svechnikova E.V., Gorskaya A.A., Artemyeva N.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9424

С ростом популярности агонистов рецептора глюкагоноподобного пептида-1 (GLP-1RA) общественность и сообщество косметологов и пластических хирургов ввели новую терминологию для характеристики некоторых непреднамеренных эффектов этих препаратов. Такие термины, как «лицо Ozempic®» и «тело Ozempic®», получили широкое распространение для обозначения потери объема тканей в результате терапии семаглутидом. Был проведен поиск в Google Trends, чтобы уточнить общественное мнение об агонистах рецептора GLP-1 и их связь с морфологическими изменениями, наблюдаемыми при медикаментозном снижении веса. Существуют некоторые данные, предполагающие, что GLP-1RA может также ускорять старение кожи, воздействуя на клетки в слое жировой ткани и подавляя их пролиферацию и метаболическую активность. GLP-1RA влияет на дермальную белую жировую ткань (DWAT) и стволовые клетки, полученные из жировой ткани (ADSCs), и, возможно, на гормональную регуляцию и мышцы лица. Для коррекции изменений, связанных с риском возникновения резкого увеличения кожного лоскута и потери объема тканей, используется широкий арсенал аппаратных и инъекционных методов. Особое место занимают инъекционные коллагеностимуляторы на основе полимолочной кислоты (PLA). После введения филлеры PLA вызывают дифференциацию макрофагов в подтип M2, который, как известно, индуцирует выработку коллагена за счет увеличения экспрессии TGF-β в фибробластах и является биосовместимым материалом, который гидролизуется до воды и углекислого газа. После введения микросферы PDLLA остаются локализованными в тканях, способствуя привлечению миофибробластов и ADSCs, что актуально для пациентов с лекарственно-индуцированной потерей подкожно-жировой клетчатки. В данном обзоре представлены основные методы коррекции и варианты сочетанных протоколов, приведены клинические случаи.

With the increasing popularity of glucagon-like peptide-1 receptor agonists (GLP-1RA), the public and the cosmetic and plastic surgery community have coined new terminology to characterize some of the unintended effects of these drugs. Terms such as “Ozempic® face” and “Ozempic® body” have come into common usage to describe the loss of tissue volume resulting from semaglutide therapy. A Google Trends search was conducted to clarify public perceptions of GLP-1 receptor agonists and their relationship to the morphologic changes observed with drug-induced weight loss. There is some evidence to suggest that GLP-1RA may also accelerate skin aging by targeting cells in the adipose tissue layer and suppressing their proliferation and metabolic activity. GLP-1RA affects dermal white adipose tissue (DWAT) and adipose-derived stem cells (ADSCs), and possibly hormonal regulation and facial muscles. A wide range of hardware and injection methods are used to correct changes associated with the risk of a sharp increase in the skin flap and loss of tissue volume. A special place is occupied by injectable collagen stimulators based on polylactic acid (PLA). After administration, PLA fillers cause differentiation of macrophages into the M2 subtype, which is known to induce collagen production by increasing the expression of TGF-β in fibroblasts and is a biocompatible material that is hydrolyzed to water and carbon dioxide. After administration, PDLLA microspheres remain localized in the tissues, promoting the attraction of myofibroblasts and ADSCs, which is important in patients with drug-induced loss of subcutaneous fat. This review presents the main correction methods and options for combined protocols, and provides clinical cases.

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The authors declare that there are no conflicts of interest present.