Maybe it's the sleepless nights many new mums endure, but Victoria Beckham didn't look her usual groomed, polished self in New York this week.
Victoria, 37, was gaunt and tired, with jutting cheekbones and circles under her eyes - a far cry from the chubby-cheeked young teen we first met in the Spice Girls 16 years ago.
So what's happened to this most famous of faces since? We asked two experts…
Heroin chic: The fashion designer appeared in New York recently with dark circles under her eyes
The plastic surgeon
Angelica Kavouni, of Harley Street’s Cosmetic Solutions clinic, says:When my patients come in for a consultation, I always ask them to bring in photos of themselves when they were younger - this, as you would expect, is the look I’m most often trying to recreate.
So I can’t help but think Victoria didn’t like herself very much during her youth, because the way she looks now is almost unrecognisable from her teenage self.
The round, full face of 20 years ago has given way to a far more sculpted ‘heroin chic’ look.
But while some women go to surgeons to try to recreate this angular shape, my ten years’ experience in the industry tells me these changes in Victoria have primarily been caused by her age and her lifestyle rather than going under the knife.
She has prominent cheekbones, but they look far more defined because her buccal fat area — between her cheekbones and jaw — is very hollow.
This is caused by a combination of age and keeping her weight so low.
We all lose fat in these areas as we get older, because it degenerates with age. But by appearing almost malnourished, Victoria is accelerating this process.
I treat about 40 patients a month and this is a trend I’ve been seeing a lot in high-profile female patients over the past five or six years.
Natural brunette: Victoria in her early days, left in 1990, before the Spice Girls became a worldwide phenomenon looks round faced and almost chubby. Right, smiling and freshfaced in 1997
It doesn’t look like Victoria has any filler in her cheeks, under her eyes or in the temple areas as these places look quite hollow and sunken.
This look doesn’t work well in the real world, as you have to wear a lot of make-up and highlight your face well to disguise shadows so as not to appear gaunt - you can see dark circles below her eyes where the fat has gone.
Her lips also look untouched at the moment, which I’m pleased about as plumped lips - as she has occasionally had in the past - would look unnatural in her slender face.
However, looking at the condition of her skin, I do think that Victoria has had Botox and skin treatments.
She has no crow’s feet or lines around her eyes, as you would expect in a woman in her late 30s, so she may have had some Botox here to combat them.
Spice as nice: Still with her trademark long brown locks early in 1998, left, and right with a cropped style as she belts out a number on stage at The Point in Dublin as part of the Spice Girls tour later in 1998
As her skin is so tight and smooth, it’s likely she has had one or more treatments to effectively iron the skin’s surface, such as the Fraxel laser or Intense Pulsed Light (IPL).
These leave the skin glowing and taut, for a cost of £2,000 upwards for a course every six months to a year.
The only cosmetic surgery I think she has had is a ‘tip rhinoplasty’ — an operation under general anaesthetic to reshape the end of her nose.
Looking at old pictures of Victoria, her nose used to have a round, bulbous, upturned tip, whereas it looks a lot more elegant and streamlined now.
It’s a popular procedure which costs from £4,500-£5,000, and if it has been done, whoever has performed the surgery has done an extremely good job.
The dietician
Priya Tew of Dietitian UK, who specialises in eating disorders, weight management and fitness, says:The most obvious change in Victoria’s face is the amount of weight that she has lost in recent years. It’s clearly starting to take its toll on her body.
As I’ve learned during my years spent with NHS and private patients, you first start to see weight loss on people’s stomach and arms, but it’s only after a while and losing a lot of weight that it starts to show on their face.
Looking at this photograph, there’s no disguising that Victoria looks underweight. Since her pregnancy, she has gone through a short, dramatic weight loss.
I generally tell my clients that as it took them nine months to put weight on during a pregnancy, they should expect it to take a similar amount of time to get it off again.
This is because, when you drop weight quickly, the body is first going to use up its muscle stores, and then start to take from wherever it can.
Blonde ambition: A bronzed Posh out and about in Monaco in 2005, left and a couple of years later announcing news of a forthcoming world tour in 2007, Victoria still has the apple-cheeked look of youth
One of the big risks of losing too much weight is that your heart muscle can become diminished, which is why anorexics often die of heart attacks.
From what has been reported of Victoria’s eating habits and judging on her appearance, it seems she has a fairly restrictive diet.
She has admitted in the past that she ate ‘only vegetables’ when she first dropped a lot of weight, and still controls what she eats.
It’s also been reported that she has followed various diets such as the ‘five hands’ diet, where you eat just five small handfuls of food a day.
I would put the hollowness in her cheeks down to a lack of fat and protein in the food she eats.
On a diet of only vegetables, she wouldn’t be getting any fat or protein and not enough carbohydrates, and even just following strict diets can leave you deficient in many different nutrients.
Gamine: The newly launched fashion designer sports a short crop and looks elfin at the launch of her first clothing line in 2008, left, and in 2010, right, Victoria is starting to look noticeably thinner in the face
And protein is also essential for skin health - collagen is a protein which is known to be a key player in skin strength and elasticity.
It degrades as you get older or if you lack protein in your diet, causing wrinkles, so it’s important to keep your protein intake up.
Victoria has been honest about her struggles with food when she was younger, and following my experience working with people suffering from eating disorders, it can be a struggle to learn to eat normally again if you have been heavily restricting your food intake.
Your body gets used to eating in a certain way, so your stomach can shrink and get used to receiving tiny amounts.
And when you start eating a fuller, more balanced diet, you can get quite bloated as your body gets used to digesting again.
There’s also the psychological aspect, and generally people need a lot of support when they’re making changes.
One problem is that, though Victoria has said she now ‘eats what a normal person does’, after years of following diets, she’s bound to be confused about what normal eating is - in fact, most people are.
Women should be aiming for a healthy, balanced diet of 2,000 calories a day.
VIDEO: A tired looking Victoria appeared at the NY launch of Britain's GREAT campaign
VIDEO: A tired looking Victoria appeared at the NY launch of Britain's GREAT campaign
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