Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide and tirzepatide have transformed obesity management, but their rapid weight-loss effects produce significant facial and cutaneous sequelae collectively termed 'Ozempic face.' These changes — including malar volume depletion, skin laxity, and accelerated facial aging — remain poorly characterized in the literature and inadequately addressed in clinical practice.

To define the anatomical and molecular changes underlying GLP-1 RA-associated facial aging, review available evidence for preventive aesthetic interventions, and propose a risk-stratified clinical framework for concurrent management.

Comprehensive narrative review of PubMed-indexed literature, pharmacovigilance databases (FAERS), conference proceedings, and registered clinical trials (ClinicalTrials.gov) through January 2026. Evidence graded using Oxford Centre for Evidence-Based Medicine levels.

Retrospective imaging data demonstrate a median 9% midfacial volume decrease in GLP-1 RA patients, with superficial fat compartments preferentially affected (~11% loss). The pathophysiology extends beyond simple fat depletion: GLP-1 receptors on adipose-derived stem cells, fibroblasts, and keratinocytes mediate direct effects on collagen homeostasis. Industry survey data suggest 48% of medicated weight-loss patients report significant facial changes within 3-6 months.

The convergence of metabolic and aesthetic medicine necessitates a preventive clinical framework. We propose a risk-stratified, phase-based protocol integrating biostimulatory, bio-remodeling, energy-based, and nutritional interventions from the initiation of GLP-1 therapy. Prospective controlled trials are urgently needed.

Proposes a structured preventive protocol initiating aesthetic interventions concurrently with GLP-1 therapy rather than reactively after weight loss completion.