The Year Everything Changed, Including My Face

Originally published on Refinery29

This past spring, approximately six months after giving birth to my daughter, Raffi, I had a revelation. I’d woken up early, which was no surprise given that even though our daughter was well into sleeping through the night, it had become harder and harder for me to sleep longer than two or three hours at a stretch. As pregnancies go, the months leading up to her birth were physically trying, too, compounded by the fact that as a high-risk pregnancy, I had barely exercised enough to break a sweat… for nearly a year.

So, there I was that bright spring morning, standing in front of the bathroom mirror, and it occurred to me, as I gazed at myself through hazy light and brain fog, that I had officially become old.

Not older. Not oldish.


I’d heard about this, the definitive moment you realize that your face isn’t quite where it used to be… it’s somewhere else, somewhere you never thought it would be. I could recall mentions of this sort of thing, here and there, in passing conversations or showing up in essays penned by women older than me. That the moment of realization — the day my face changed or, I’m just going to say it here... the day my face fell — wouldn’t exactly be gentle. I suppose, if you’re lucky, and I think I have been, cardiovascularly living with a purpose through one’s thirties and forties, you can keep such prominent markers of middle-age reasonably under wraps. With good lighting, decent facials, and the right concealer, I could get away with looking five, even 10 years younger. Add a few good night’s sleep on the pile, and forget it, I was practically radiant.

Not many people I know talk about turning 50. Probably because most people that everyone knows — ie: celebrities and other famous people — have rarely talked about turning 50 until recently (thank you J-Lo). And, I’ve spent some time this past year thinking about why that is, and, honestly, wondering if it’s even safe to discuss it without the threat of consequences, professional or otherwise. It’s no secret that sexism and ageism continue to be very real obstacles in our professional growth, and yes, despite some minor strides in pay equity between men and women over the past five years (the pay gap is down 2.7% since 2016), many of those "clichés" still ring true: As men age, they’re seen as more competent at work, more distinguished, better compensated, and more valued. But for women, it’s different. Crossing the 50 mark, women don’t just feel less visible out in the world, they can often be devalued professionally as soon as they start to show signs that they’re getting older, as Forbes reported.

The truth is, I never expected to have a baby at 49. I certainly never expected to turn 50 two months after she showed up. But what I really never expected, harder than those two other major things, was how I would feel about my face after it all went down (literally).

I’m definitely not the most vain person, but I’m also not someone who gives nary a shit about how she looks. Believe me, I care. And, I certainly wish at moments that I didn’t, but there is something about having a kid when most other parents and friends your age are getting their own children through middle school that puts your age — and your looks — in perspective. We’ve all heard about the mixed feelings many women have about their bodies after having babies, and I was no exception. I was genuinely proud, even in awe of what my body could do, but truthfully, everything felt strange, unfamiliar, and, well... sort of jiggly. Beneath my clothes, who even knew? My face though, after all those nights awake wondering if I would ever sleep again... there was no hiding it.

And, I’m going to be really, really honest right here: It made me unbelievably sad.

It didn’t matter that I was scrubbing and peeling and rolling my face like a mad person. That particular morning was a wakeup call. I needed help, someone who could guide me in this new and unknowable phase of my life, when, on top of everything else, smarter, fancier skincare would need to play a bigger role. What changes could I anticipate, what treatments might I want to think about, and what did my body and face need now that apparently my collagen — that stuff that keeps everything from drooping and makes overhead lighting the absolute WORST when it’s gone — was diminishing at an astonishing clip.

I thought back to the last time I had a major skin-care moment, when I was 45 and decided to try Botox for the first time, so I went back to see my dermatologist Francesca Fusco, MD, to get some advice about what I could do — and how I would look — with some additional experts in the mix. I called everyone I knew with experience in the cosmetic dermatology space, and eventually I found myself meeting with Matthew White, MD, a NYC-based plastic surgeon who’s known (affectionately) as The Neck Guy. Personally, I feel pretty fine about my neck, but I liked what I’d read and heard about him. That yes, he was a surgeon, but he also had a reputation for being thoughtful and relatively conservative in his approach, not to mention extremely knowledgeable about the different technologies and treatments available for wiped out skin like mine.

At the height of sleep deprivation with my daughter, Raffi, who was born just two months before I turned 50.

Listening back to my earliest conversation with Dr. White, which I recorded, he shared a story about how he once talked a young woman out of a rhinoplasty procedure, mainly because he had a hunch she wasn’t entirely committed to it, she was just responding to other stresses in her life, which were temporary. “It’s weird,” he said. “Some of my prouder moments as a doctor aren’t the work I’ve done, but the times I’ve been able to talk through things with patients to uncover what they really want and feel about themselves. That’s the only way I can work and help someone feel better about themselves.”

Until that point sitting in his office in Manhattan, I hadn’t realized how unsettled I’d been about my own perception and fears of aging, now that I found myself with a newborn. In everything that I had been through to get to this place, I was genuinely unprepared for this underlying fear of judgment for maybe looking too old to be a new parent—which made me think about my face so much differently than I ever had before, which also triggered guilt and even disgust, that I cared as much as I did. If a friend confided she wanted to see someone about her tired face, I would be encouraging, but doing it for myself was trickier. I was never so happy now that I was learning to be a mother, so why so much self-criticism? Did I need more therapy or plastic surgery? Could they somehow be one in the same?

Dr. White, who is known for his conservative approach, says there is a double-standard for women and aging. Photographed by Jessie English.

I think I was drawn to Dr. White’s philosophy initially because it helped simplify things. He refers to it as The Foundational Approach to Facial Aging, which taps into “the new science of how and why faces age.” Not just my face — everyone’s face at any age. The goal is to spend as much time as possible evaluating his patient’s distinct characteristics and then identifying which layer of the face needs attention. “Multiple anatomic layers co-exist together in the face to give it shape,” he says. “Understanding these layers, and each of their contributions to aging is critical, specifically in selecting the right treatment.”

I was curious about Dr. White’s view of his own profession, and the conflict that exists between the parody of plastic surgery and the root of why people genuinely seek it out. “There is definitely a double standard we hold women to and an unrealistic beauty ideal that’s widely portrayed,” Dr. White said. “Society and the media idealizes youth, but then also openly criticizes when someone attempts any intervention to maintain a youthful look. It’s not healthy. In my opinion, true beauty is individualized and natural, and we need to celebrate that uniqueness, not cover it up.”

Dr. White underwent four major surgeries for a childhood condition, which taught him empathy. "I know what it’s like on the other side of the operating table,” he says. Photographed by Jessie English.

Regardless of someone else’s choices (which I completely support), I wasn’t emotionally ready for anything surgical, not yet, at least. Instead, Dr. White and I talked about what my skincare routine looked like now, and what it might look like five years from now, even 10. We talked about the areas of my face that made me self-conscious: a deep vertical crease between my eyebrows, some sagging around my mouth and cheeks, and the tell-tale dark shadows and bags under my eyes, a condition that’s only gotten worse as good consistent sleep has been harder to come by.

From Dr. White’s perspective, I just needed a little “lift” as my main concern was what he called early laxity or sagging. For this, Dr. White recommended some strategically placed Juvederm filler, but more importantly, one session of Ultherapy, allegedly, the first treatment capable of delivering energy at a depth that other devices (lasers, radiofrequency) can’t. “As a result, the lifting and tightening effect of the facial tissues yields a noticeable result,” said Dr. White. Though it’s important to note that it can take up to six months to see any change, and personally, I found the treatment, which took about an hour, to be a bit painful, especially around my jawbone.

Now that I'm here, I have a tremendous amount of respect and compassion for what it means to have gotten to this place at all. It was hard work. And sometimes, it shows.

One thing Dr. White wouldn’t touch was my eyes, sharing that he himself was extremely focused with the face, jawline, and neck, but for areas outside his focus, like the eyes, he preferred to work with other specialists, like professor and Ophthalmic Surgeon or eyelid surgeon Ebrahim Elahi, MD. Dr. Elahi is one of those wonder doctors you might have to wait a few months or more to see. And, my dermatologist, Dr. Fusco, agreed he was the only person to discuss my particular perma-tired eye situation with, which is understandably more complicated than smoothing out a deep line on my forehead. When I finally met with Dr. Elahi, we talked for a while about the pros and cons of surgery versus under-eye filler, especially for someone like me who was extra scared of doing anything too extreme. He admitted, if I wanted 100% satisfaction with the results, I should opt for a surgery called a Lower Blepharoplasty, or Lower Eyelid Lift, which requires an (unsettling) incision on the interior side of the lower lid to remove excess tissue and fat to lift the area to make it smoother.

I mean, I cringed a bit when he first mentioned eye surgery… me? What? But he also reassured me, in his opinion, it could wait five or so years, when my issue might be more pronounced. In the meantime, under-eye filler could provide “70%” of the rested-looking satisfaction” I was aiming for.

For me (and my face) 70% pretty much is perfect. Because I don’t have any designs on being or looking younger. In many ways, I appreciate and respect how my face is changing along with my own evolving perception of beauty. Sleep or no sleep, 30, 50, or 70 — those changes are mine, and I’ve earned them, for they could be the greatest personal evidence I have of a life that is genuinely being lived... bags and all. Having a baby and turning 50 shortly after have catapulted me to a place where I don’t just look different... I am different. And, looking different, albeit a little less tired and saggy thanks to some subtle tweaks, is okay with me.

Dr. White told me Ultherapy, a treatment that lifts and tightens the skin around the jawline and neck, would keep me from looking tired all the time (even though I was).

Another big reality of this process is cost, or perhaps more accurately, the price and privilege of looking permanently rested (even if you’re not). One session of Ultherapy, plus one round of filler and Botox can cost anywhere from $6k to $10k, and full transparency, I didn’t receive any of my treatments for free, but some of the fees were discounted with a media rate. Which poses another question — would I even care this much about aging if I didn’t have the money or access to pay for it? As someone who doesn’t spend a notable portion of recreational funds on specialized “beauty” treatments, I had to come to terms with how much feeling better about my face was worth to me. Having written about getting Botox before, I’m abundantly aware of the opposing views on such stuff — some people see treatments as vain and unfeminist, while others see such perceptions as hypocritical and overly judgmental.

I can see both arguments. But mostly, I had to put other people’s opinions about my face and what I did with it to the side. Like many people I know and love, I’m hard enough on myself. And, now that I’m here, I have a tremendous amount of respect and compassion for what it means to have gotten to this place at all. It was hard work. And sometimes, it shows.

My daughter is walking now, starting to say things like mamamama, and as all my closest friends assured me, I am getting more sleep than I was six months ago. I started seeing a trainer in my neighborhood once a week, and I try to be loyal to a nightly ritual of early bedtime, reading, taking notes in my journal, and, sometimes, just breathing out anything that’s worrying me (having a new human to keep alive is, surprise, stressful). I’ve been reading Gloria Steinem’s memoir My Life On the Road, I think because I feel an inherent pull in everything I’m taking in right now, to honor the particular road I’ve traveled to get here. In the book, there is a quote from a woman Steinem meets on the road that makes me think about how I feel now when I look at my face in the mirror or think about how different I am from just a year ago: “You're always the person you were when you were born. You just keep finding new ways to express it.”

Dr. White performed my Ultherapy, but recommended I see another specialist for under-eye filler, which is trickier. Photographed by Jessie English.

There is a deeper truth, one that keeps coming back to me — change is HARD. It doesn’t matter if you see it coming or not, stepping from one life into another, from one decade to the next, as we all are right now. Taking time or even just a moment to mourn the old life you’ve outgrown... the face you used to have, before this new life happened. And giving yourself space to feel at ease, even excited about the new one emerging. I don’t always recognize myself by these new identities: Working mother. 50-something. Or just a happy, often exhausted person who’s doing the best she can. Which is why looking in the mirror can occasionally be jarring. I have to look closer, with good light, to see what’s really going on. And most of the time these days, I’m okay with it.

Photographed by Jessie English.