By Valerie Monroe
If you’re interested in feeling happier about your appearance—especially as you age—you might like reading what she has to say about it. For more of her philosophical and practical advice, subscribe for free to How Not to F*ck Up Your Face at valeriemonroe.substack.com.
Can’t get enough Valerie Monroe? There’s more at https://valeriemonroe.substack.com.
I RECENTLY felt compelled—Marie Kondo-style—to curate my (smallish) skincare collection, pitching anything that was more than 10 (or 20?) years old. Then, I received several emails from readers declaring they’d recently thrown out various skincare products they’d bought and never used. Then, I saw this in an essay by Anne Lamott in The Washington Post.
. . . So twice a year I go to Sephora and announce that I’d like to buy a miracle, and wonderfully, they always have the exact right thing. I use it for a month, and then I put it in the bottom drawer with the other miracles . . .
That excerpt reminded me of something I wrote not long ago about an extremely popular and expensive skincare product. From there (still with me?), I asked myself the question I often do when compelled to buy something I don’t need: What is it I really want right now? Most of the time it’s not what I’m thinking of buying.
Sometimes I realize I’m just thirsty—literally. But I’ve recently discovered it can be fun to shop your own closet (or bureau, or jewelry box). You might find—as I have—that that adventure has become particularly interesting since the pandemic, if you, like me, now wear 1/100th of what you used to wear. Which likely means you haven’t been acquainted with a lot of your stuff for several years.
Is it too far a leap to then ask yourself, when you look in the mirror and are less than happy with your reflection: What is it I really want right now? Sure, maybe the answer is a facelift. But it’s worth asking the question and taking the time to give it thought.
More zeitgeist material: A few questions arrived simultaneously from readers in different circumstances with a common issue: marionette lines.
Q: I turned 59 in November—yikes! I already decided I’d never get a facelift after I saw what my mom went through 39 years ago. I’m sure things have changed, but the way she looked post-op is a vision I’ll never forget. I have olive skin and I’ve had surgery resulting in scars. But my question is about my marionette lines, which seem to be getting deeper. I lost about 40 lbs, so my elasticity has seen its day. What can I do for this? Which of the thousands of serums out there could help but won’t cost $500 a bottle? There has to be a product that’s both reasonably priced and can actually help.
A: When I think about responding to some of your questions, dear Readers, I’m afraid HNTFUYF will feel like doom scrolling. I ultimately confessed to this reader that I could offer her nothing: No cream, no serum, no lotion would relieve her of her deep marionette lines. I’m sorry! So sorry! But I’m not wrong.
“Unfortunately, the results of a 40-pound weight loss won’t be improved significantly with any topical product,” said HNTFUYF DermDiva Heidi Waldorf. “If you’re looking for a visible, lasting change, you’ll need to consult with both an experienced cosmetic dermatologist and a plastic surgeon to determine your surgical and non-surgical options.”
As for the non-surgical options, that will depend on your chronological age, your apparent skin age (based on how you’ve been caring for your skin and the effects of any treatment or procedures you’ve had), and what percentage of your original body weight 40 lbs represents. You may find, however, that surgery is the only option that will give you the tightening and lifting you’re aiming for, said Waldorf. So be very attentive during the discussion with your dermatologist or surgeon of realistic expectations.
“The scars you mention are another issue,” said Waldorf. “Unless they’re in areas that would either be removed during surgery or can be surgically removed without leaving more scarring, they can be treated with combinations of energy-based devices like laser and radiofrequency; device-assisted drug delivery; or injections including corticosteroids, fluorouracil, botulinum toxin, plasma, and biostimulators and fillers. All of those options can require multiple treatments and can also improve both skin tone and scarring. But there’s no one procedure—and certainly no topical cream or lotion—that will address everything.”
Oof. In my personal email to the reader, I ended with this:
“I’m going to give you more of my broken-record advice: No one looks at you with the same critical eye you see yourself; what’s noticeable to you might not be noticeable at all to others, or barely. Please try to keep that in mind when you look at your reflection. And avoid scanning your face for flaws!”
AND
Q: I have been embarrassingly obsessed about my facial signs of aging. Especially my marionette lines, which have deepened and are even worse when my face is resting. I turn 40 in March. I’m trying to get pregnant with my second baby and I have autoimmune disease. This means I cannot use retinol right now (although I know that won’t help with my marionette lines) and I will never be able to use fillers. I’ve read your article on no retinol during pregnancy. And fillers, well it’s probably a good thing I’ll never use them. But the lines around my mouth: What can I do about these?
A: Trying to get pregnant with your second baby! Sounds like a full-time job. Waldorf started out upbeat with a reminder. “First, if you do get pregnant—and I wish you the very best that you do—your face will fill out. So those marionette lines will be less visible,” she said.
Let’s just stop for a moment to give thanks for what the female body can do. All the changes it goes through to produce another human!
“But until you get pregnant, you can have fillers,” said Waldorf. “The only issue is if you get one of the very rare complications afterward during pregnancy that requires medications you wouldn’t want to have to take during that period.” (I have zero chance of getting pregnant and even so, this reasonable warning gives me pause.)
“Second, autoimmune disease is not a contraindication to filler,” she said. “That’s a holdover from the old days of bovine collagen when there was a concern about links to [rheumatological] disease,” said Waldorf. Currently, the only filler containing bovine collagen is Bellafill. Unless you’re having an active flare of your underlying autoimmune condition, you can still have fillers consisting of hyaluronic acid and calcium hydroxylapatite gel, she said. This is a good time to refer back to Waldorf’s excellent general advice about filler, a must-read before you’re injected.
“Another option is a tightening procedure before pregnancy with radiofrequency or ultrasound technology, which generally takes about six months to fully kick in,” said Waldorf. If your face becomes fuller during pregnancy, you likely won’t notice the difference, but you should be able to notice it after you’ve delivered, she said. After the first trimester, you can also undergo this kind of procedure but Waldorf says you shouldn’t have topical, oral, or inhaled anaesthetic.
Having tried several of these treatments myself, I think you might want to skip them without an anaesthetic. In fact, reading through Waldorf’s thorough response, I wonder if you might want to wait till your body is done with its great big job before you tackle the issue of what’s annoying you facially. If you do get pregnant, you’re going to look—and probably feel—different about yourself after the baby arrives, as I’m sure you know. Might that be a good time to reassess your marionette lines?
As you correctly pointed out, dear Reader, no topical will reduce them, not even retinoids. But speaking of topicals, it’s most important to wear sunscreen during pregnancy, especially if you have a history of melasma (which can be exacerbated by pregnancy), says Waldorf. Topical poly-and-alpha hydroxy acids, azeleic acid, and peptides are all fine to use, she added, but don’t bother with products marketed specifically for pregnancy; they’re unnecessary.
Most important, she says, follow your obstetrician’s instructions to maximize your chance of a baby. A baby! Oh, and put away your magnifying mirror.
