💌 "Ozempic Face" is now a thing, ulnar nerve insights, & updated clinical cases.

With the global spike in obesity, the hunt for effective solutions has been fervent. Making waves in this space are Ozempic, Wegovy, and Rybelsus - all champions of semaglutide. While they're predominantly in the diabetes ring, they're also making off-label appearances in the weight loss arena.

But here's the curveball: Ozempic’s rapid weight loss magic can morph into the “Ozempic face,” marked by drooping skin and enhanced wrinkles due to the dip in facial fat. Picture shedding those cherubic cheeks only to be greeted by a prematurely aged reflection!

What do the trends show? Quick Dive into the Latest Trends:

Cosmetic surgery is not just in vogue, it's exploding! There’s been a 19% surge since 2019.

• Facelifts alone have climbed by 8% in the last year. Given the “Ozempic face” trend combined with our selfie-dominant era, this spike doesn’t really shock.
• Eyes are capturing attention, with eyelid surgery ranking fourth in popularity.
• And, let's roll out the red carpet for lip augmentation! Clocking in a staggering 1,378,631 procedures in 2022, it seems like the globe is all set to flaunt those plush lips post-lockdown. Kudos to the influencer brigade!

In a Nutshell:

While Ozempic and its kin dangle the allure of a trimmer silhouette, they come packaged with the unintentional tag of accelerated facial ageing. As we ride this wave, let's ensure our dialogues remain open, guiding our patients with top-tier advice.

Cheers and chat soon,

P'Fella ❤️

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Hey there!

This is a great question.

Thanks for bringing up this question about mixing lidocaine and bupivacaine. It's a grey area with varying practices. I personally do not mix local anaesthetics.

Both these local anaesthetics are amides that block sodium channels to stop nerve signals. Some folks mix them for a better balance of fast action and long-lasting relief, while others stick to one based on the situation.

The main thing to watch out for is keeping the total dose within safe limits to dodge toxicity. Some references like Budney (2019) suggest sticking to a combined max dose. So, if you go half-max on lidocaine, the other half should be the max you go with bupivacaine.

For a quick example, in a 50kg person, 10ml of 1% lidocaine is half the max dose, and 10ml of levobupivacaine at 2.5mg/ml is a quarter of the max. Mixing 20ml of these two stays within the 75% of the max dose, which is on the safe side. But a 40ml mix hits 150% of the max, which could lead to trouble.

Throwing adrenaline into the mix can up the max dose allowance for lidocaine, letting you use a larger volume safely (French, 2012)

Hope that clears things up a bit. Feel free to bounce back any more questions or thoughts

P'Fella