All Wrinkles Are Not Alike

Photo-Illustration: The Cut; Photo: Getty

Q: Every time I smile, the skin on my cheeks starts folding up like drapes when you open them. Actually, I’m okay with that, but now I’m starting to see vertical wrinkles on my cheeks even when I’m not smiling! I’m worried these vertical lines will be too deep to do anything about one of these days. Help me!

A: There are lots of people who say the best beauty treatment is a smile — and it’s true that a pleasant expression can make you seem more approachable, so I’m glad to know that your wrinkle situation isn’t inhibiting you from smiling. But I understand why you might find it concerning when you begin to notice the effects of your expressions remind you of certain home décor. In the interest of alleviating your worry, I asked HNTFUYF derm diva Heidi Waldorf for her best advice.

“Folds of skin are a sign of laxity and/or volume loss,” she said. To clarify: Laxity means the skin no longer remains taut because of a damaged, thinned epidermis (outer layer) and reduced collagen and elastin in the dermis (the layer just below the epidermis). Volume loss means the erosion of the underlying structures in your face — the fat, muscle, and bone — that support the overlying skin. If this sounds like the road to Scarytown, it’s not; it’s the normal process of an organic system (your body) as it ages.
“The persistent ‘vertical lines’ you’re noticing are the wrinkles that result from that skin folding on itself with movement and rest,” said Waldorf. Whether a noninvasive procedure—like resurfacing to improve the skin texture, tightening to stimulate collagen, or injecting fillers to replace lost support—or an invasive surgical procedure like a face-lift would work to alleviate the wrinkles depends on how much either laxity or volume loss is contributing to the issue.

Who knows? Not me. So I agree with Waldorf about how you might proceed. “Rather than worrying about whether it will be too late to address ‘one of these days,’ go for a consultation now,” she said.  An experienced cosmetic dermatologist can determine which procedures might help, to what degree, and at what damage to your wallet. “They can also refer you to a plastic or facial plastic surgeon for evaluation. Then it might be easier to make an informed decision about what you do and don’t want to do,” said Waldorf.

I have some additional advice. From the time we start recognizing ourselves in our reflection, we (females, mostly) are taught to objectify what we see — in other words, to treat our face (and body) as an object to be evaluated and adorned. This is called the theory of objectification. So instead of actually seeing ourselves the same way we see people who aren’t us, we only see what we think others see. If that’s not the opposite of a good idea, I don’t know what is. And because what’s promoted as attractive or beautiful in our mainstream culture is still limited — overwhelmingly Caucasian-featured even when skin tone is dark, and very youth-oriented — we might find it increasingly difficult to avoid being critical about what we see in the mirror. Especially as we notice aging’s inevitable effects, such as the drape affair in which you’ve found yourself.

It’s what you project onto your reflection that determines how you evaluate it. For example, have you noticed that you are, like me, generally fine with how you look when you feel accomplished and respected but worried about looking raggedy when you feel insecure?

If you can unlearn what you have learned, if you can look at yourself without objectifying, your face becomes just another face — with small blue eyes or large brown ones, a ski-jump nose or a long narrow one, or wrinkles — that no one is judging. And when you can look into your own eyes long enough to allow emotions to rise up and to stay present with them, you will have the same response to yourself as you would when looking into a friend’s eyes as she confesses her most intimate feelings. If you’re the kind of friend I think you are, what you’d be doing is called deep listening. It’s one of the kindest things you can do for another person. Only you’re doing it for yourself.

The upshot of this exercise (called mirror-meditation) is that whatever you choose to do about your appearance — whether something invasive as surgery or nothing at all — you will likely be more satisfied with the results. So sure, have a consultation with a board-certified doctor (and don’t forget to ask if there’s a fee for that when you make the appointment). But you can also take good care of yourself with only a mirror and the intention to see your face beyond the mask you show the world.

Valerie Monroe was beauty director at O, The Oprah Magazine, where she wrote the monthly “Ask Val” column for nearly 16 years. Now she writes the weekly newsletter How Not to F*ck Up Your Face. Her goal continues to be to shift our thinking in the beauty arena from self-criticism to self-compassion and to learn how to be loving witnesses to ourselves and one another as we age.