Restoring Facial Volume After GLP-1 Weight Loss With Radiesse

Inclusion Criteria:

* Adults aged 21-65 who are initiating GLP-1 therapy (semaglutide, tirzepatide, or similar) for weight loss or diabetes-related weight management with targeted weight loss of 20 pounds or more
* Participants must have a body mass index (BMI) meeting indications for GLP-1 therapy and within the range of 24-32
* Participants should be at the start of GLP-1 therapy (baseline visit scheduled at or within 1-2 weeks of first GLP-1 injection) so that baseline facial measurements represent their pre-weight-loss state
* Participants must have noticeable facial subcutaneous fat (no pre-existing extreme lipoatrophy) and be willing to receive facial filler injections
* Participants should be able to comply with all study visits and procedures up to 12 months
* Participants must provide written informed consent, including consent for facial imaging

Exclusion Criteria:

* Participants with any prior facial cosmetic procedures that could confound results e.g. facial filler or fat transfer in the past 2 years; thread lifts or energy based device facial treatments in the last 1 year; microneedling, botulinum toxin treatment in the depressor anguli oris (DAO), or chemical peels in the last 4 months; or a history of surgical lifts and/or liposuction
* Participants currently using a retinoid
* Participants with active dermatologic conditions affecting the face (e.g. severe acne, psoriasis on face) or scars that would interfere with volume assessment
* Participants with known allergies or hypersensitivity to CaHA or lidocaine (lidocaine allergy)
* Those with a history of severe anaphylactic reactions requiring epinephrine (due to risk with injectables)
* Those with uncontrolled diabetes or major comorbid conditions that would make participation unsafe (e.g. bleeding disorders that contraindicate injections, immunosuppression that raises infection risk, uncontrolled psychiatric illness such as body dysmorphic disorder)
* Pregnant or breastfeeding women are excluded (GLP-1 therapies are contraindicated in pregnancy, and elective filler is avoided in pregnancy)
* Women of childbearing potential must agree to use an effective contraceptive method during the study (though pregnancy during the short study window is unlikely, this is a precaution)
* If a Participant becomes pregnant or initiates any new facial cosmetic treatment during the Study, they will be withdrawn
* Participants planning bariatric surgery or other significant weight loss interventions (besides the GLP-1 medication) in the study period