Saskia de Tollenaere works in a variety of media, and is particularly noted for her carefully crafted sculptural portraits of historical figures. Each portrait skull is rich with symbolism, much of which is not immediately obvious to the viewer.

In this portrait of Catherine de Medici, the skull is fashioned from a deep green velvet with period bullion thread embroidery, and on top of the skull is a golden crown. The nine stems of the crown are supported by ten porcelain dolls, each signifying one of the eight single children to whom she gave birth, and a pair of twins which the artist has placed back-to-back in the centre of the crown. Medici believed strongly in astrology, and maintained a close friendship with Nostradamus. At the top of each of the stems of the crown are coins of the zodiac, nine across the crown and two hanging as earrings, with the twelfth sign held by the second twin at the back of the crown. The zodiac signs are portayed by animal and human skeletons, in keeping with the skull of the portrait, and on the central stem is the personal zodiac sign of Medici herself, Aries.

A famous story about Catherine de Medici tells of her spying on her husband the King and his mistress. The artist refers to this by constructing the right eye as a keyhole with a sliding cover. The viewer can light the keyhole with their phone, and an erotic scene is revealed from within.

Under the skull is a collar fashioned from gloves, which Medici introduced to the French court. The fashion at the time was for the gloves to be perfumed, and so they were known as sweet gloves. Suspended from the gloved hands, are five red balls. The Medici coat of arms was made up of five red balls and one blue ball on a gold shield. The blue ball can be found on the back of Medici's hair, adorned with the symbol of the Kings of France - three golden lilies.

Suspected for much of her life to be a sorceress, Medici is known to have poisoned many of her enemies. Dangling from each earring are the artist's final flourishes, tiny vials of poison.