A Note From Me 10 Years Later
Almost 10 years ago, when I was first starting Charlotte’s Book, Dr. Shereene Idriss wrote this article for me. I came across it recently and realized something: the advice still holds up. Really well.
A huge shoutout to Dr. Shereene Idriss, who worked with me in those very early Charlotte’s Book days. She was brilliant then, she’s brilliant now, and I’m incredibly grateful to all the doctors who took a chance on my little platform before anyone really knew what it was.
Back then, Charlotte’s Book grew into a full-fledged beauty website. Then life twisted a bit. I dropped the ball. And now I’m back on Substack. But through all of it, I kept that content alive and well.
Ten years later, after writing endlessly about aging and eventually getting a facelift myself (Allure documented it), I’ve now actually experienced what Shereene was describing. Her analogy is evergreen, incredibly accurate and, at this point, strangely personal.
Yeah. Your face is basically a couch, just like Shereene said. I like to think that mine is at least a really expensive B&B Italia couch. But it ages like one nonetheless.
Good intel like this doesn’t need to be reinvented, and this article is just as accurate today as it was 10 years ago. Smart and thoughtful cosmetic doctors explain what is actually happening to your face so you can make smarter decisions about what, if anything, you want to do about it.
So here it is again, from the Charlotte’s Book archives, written by Dr. Shereene Idriss. Originally published October 22, 2017. Republished below and unpaywalled for your reading pleasure. Ten years later, the article is holding up beautifully. Unlike my jawline, which required professional assistance.
The Couch Analogy
To keep it simple (or, as simple as can be) let’s compare your face to a couch: you first start by noticing a small stain (note to self: avoid red wine when hosting parties), which can be lightened to appear invisible.
With time, that stain becomes more prominent as others appear around it, making the fabric appear discolored. Then, one day, you notice the fabric isn’t as firm as it used to be, having lost its elasticity in some areas.
Upon further inspection, your once plump and heavenly cushions have become saggy and sunken, exposing parts of the sofa’s skeleton. And then, the final stage, the last mortal blow, is the day you attempt to sit on your couch and the sturdy framework that lent you faithful support all of those years, finally gives in and crumbles.
This, my friends, is your face in a nutshell.
The Reveal
The fabric is your skin, revealing the earliest evidence of aging through discoloration. The plump cushions can be likened to your once youthful cheeks made up of all of the underlying glorious muscle and fat.
And, the framework, the pièce de resistance holding it all together, is your facial skeleton.
Like any chronic process, you don’t fully appreciate the changes of your facial skeleton until they are quite advanced. Minimal changes in your framework are masked through time by the superficial cushioning of your facial muscles and fat pads, until redistribution and loss reveal a frail structure.
A Closer Look: Bone Loss
The implications of facial bone loss on the aging face are crucial to understand in order to restore a natural youthful appearance.
By early adulthood, maximum bone density is achieved in both men and women. As we approach our early 30s, bone density begins to experience a gradual rate of decline. Unfortunately, women tend to undergo a more significant decrease in facial bone volume starting at a younger age, hence lending credence to the universal truth of women aging faster than men.
Four main areas undergo change resulting in dramatic repercussions:
1. The orbital rim (aka eye socket) widens, particularly along the outer inferior edges, giving your eyes a more sunken appearance with more prominent fat pads resulting in a tired look.
2. The mid-face recedes, softening support to overlying structures.
3. The nasal cartilage separates, lengthening the nose and dropping the nasal tip.
4. The mandible (aka jawline) retracts, unveiling jowls and an unstructured neck. All of this happens almost simultaneously, like a carefully orchestrated attack on your youth. The facial muscles and fat pads decrease in volume, while the casing holding them together (the superficial muscular aponeurotic system aka SMAS) loses its elasticity, culminating in a true domino effect. From the top down, your temples appear more sunken lending way to the formation of heavy pads beneath your eyes, followed by strong folds around your mouth, weighing down the corners of your lips resulting in jowls along your jawline and the appearance of a saggy neck.
Knowledge Is Power
With this understanding, you are now better equipped to understand your options when considering cosmetic work.
If your goal is to age gracefully, quick fixes are not your solution. For example, avoid cheek implants as you will only continue to age around them—and trust me, this is not a good look.
Likewise, filling the folds around your mouth with injectables will only result in the dreaded “muzzle” look. The answer, my friends, is “maintenance” through regular use of a thorough toolkit that should include daily basics such as SPF and antioxidants to periodic treatments with lasers, ultrasound, LEDs, fillers and neuromodulators.
What it boils down to is strengthening your foundation through many little interventions along your journey through life. Like that sofa, our skin will inevitably age, but there is a lot you can do to delay the inevitable and embrace it gracefully.
I can’t believe this was from 10 years ago! Thank you for keeping it alive