GLP1s do not themselves cause any worse muscle loss than you would experience if you lost the weight by watching calories the old fashioned way.
"Ozempic face" is almost certainly an artifact of people who spent their life significantly overweight having somewhat looser skin than they would if they had maintained a low weight throughout their life.
Also, not everyone gets the face effect, not by a long shot.
Yeah exactly, what people call Ozempic Face is often just wrinkles. I look a bit older now that I lost 40 lbs, but much healthier shape. Fat does fill in your face some
Not really, Ozempic face is the same face as one gets when starved of food for a longer period of time from low caloric diet that contains carbs. Ketosis on the other hand doesn't cause this unless one has almost no fat left as it doesn't switch body to the starvation mode.
There are two modes the human body operates normally - insulin-driven, active when carbs are in the food, and ketone-driven, active when there is a lot of fat storage and no food intake, or food has no carbs. Insulin-driven operation switches to starvation when food intake has caloric deficit but still enough carbs for insulin to be triggered; ketones on the other hand lead to zero insulin activity and pure fat burning; starvation is only activated when humans reach around 4% body fat while in ketosis.