General guidelines are: Lips: 612 months Cheeks: 1224 months Jawline / Chin: 1218 months Under Eyes: 918 months Temples: 1224 months Thicker, denser structural fillers tend to last longer than softer formulations, such as those used in the lips
Patient monitoring should include: Baseline lipid panel, hemoglobin A1c, and liver function tests Blood pressure monitoring (GLP-1 agents typically reduce systolic BP by 3-5 mmHg) [10] Assessment for gastrointestinal adverse effects during dose titration Evaluation for contraindications (personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia syndrome type 2) [1] [3] Monitoring for gallbladder disease (increased risk with rapid weight loss) In patients with diabetes and retinopathy, monitoring for worsening eye symptoms, particularly with rapid glycemic improvement Renal function assessment, especially if severe gastrointestinal symptoms cause dehydration Patients should seek immediate medical attention for severe abdominal pain, which may indicate pancreatitisa rare but serious adverse effect
References: Ozempic list price explanation, Novo Nordisk (2024) Patient Assistance Program (PAP), Novo Nordisk (2024) Wegovy list price explanation, Novo Nordisk (2024) Rybelsus list price explanation, Novo Nordisk (2024) Semaglutide market report, Grand View Research (2024) FDA clarifies policies as GLP-1 supply stabilizes, FDA (2024) Compounded semaglutide: how to better ensure its safety, Medscape (2024) Illicit compounding position, Novo Nordisk (2025)
PI3K/AKT activates the mTOR pathway but inhibits the FoxO1/O3, GSK-3, and NF-B pathways
There are some important contraindications for taking GLP-1 medications: a severe allergic reaction to a GLP-1 medication in the past a history of pancreatitis pregnancy or breastfeeding a history of medullary thyroid cancer or multiple endocrine neoplasia type 2 in yourself or an immediate family member Finally, cost and access need to be considered
