Cosmetic and Laser Updates: GLP-1 Facial Changes, Biostimulatory Fillers, Microcoring, and Emerging Treatments

Conclusions

• GLP-1–associated weight loss can produce noticeable facial volume loss and skin laxity, so early intervention with fillers and biostimulatory agents may help patients maintain a more natural appearance while continuing treatment.
• Combined hyaluronic acid and poly-L-lactic acid regimens appear to improve facial contour, skin thickness, hydration, radiance, and patient satisfaction in people using GLP-1 medications.
• Poly-L-lactic acid is emerging as a regenerative biostimulator not only for the face but also for off-face body areas such as the neck, chest, buttocks, arms, knees, and abdomen, with benefits that may last for years.
• Dermal microcoring can meaningfully reduce moderate facial wrinkles and some body laxity, but its benefits are technique-dependent and it may still cause visible grid-pattern scarring, so it is not entirely scarless.
• Botulinum toxin has expanded beyond wrinkle treatment and can be useful for hyperhidrosis, Raynaud phenomenon, Hailey-Hailey disease, seborrhea, rosacea, and enlarged pores.
• Topical liposomal botulinum toxin may offer a less invasive alternative for axillary hyperhidrosis, but injectables still provide a more established effect.
• Botulinum toxin A can improve Raynaud symptoms, finger warmth, ulcer healing, and swelling, suggesting a real vascular and symptomatic benefit in selected patients.
• Perilesional botulinum toxin A can reduce pain and lesions in Hailey-Hailey disease, and lasers may provide longer remissions in more severe cases.
• Perioral hyaluronidase injections can improve microstomia in systemic sclerosis, increasing oral aperture and function in a way that patients may find life-changing.
• Botulinum toxin E introduces a new cosmetic neurotoxin option with very rapid onset and very short duration, making it especially attractive for first-time or event-based users who want temporary results.
• Microdroplet botulinum toxin techniques may provide modest lifting effects and can improve seborrhea, acne, rosacea redness, and facial pore size when placed superficially and carefully.
• Microcoring may also be useful for enlarged pores, offering a more durable but procedure-based alternative to microbotox.
• Ultrasound-based skin tightening is a safe non-surgical option for mild to moderate laxity because it targets deeper tissues while sparing the epidermis and working across skin types.
• High-intensity parallel ultrasound shows promise for acne atrophic scars by stimulating collagen remodeling with minimal downtime, broad skin-type applicability, and strong early safety and improvement signals.