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The unflattering picture can just be a moment. So the lack of a smile is not an issue.

No tiara or order may be the result of a mistake. HRH lives basically across from Laecken so i think she was able to dress at home to go to the dinner. Possibly she opted not to put a purple Belgian order with a bright red gown (im not sure she has an Italian order).

Why she did not wear a tiara we don't know. Maybe the lack of a smile had to do with a serious headache and that would also explain why she opted not to wear a tiara for the event. But that is pure speculation.

I would love to see her create a frame for the emerald necklace her husband inherited. That would make a very stunning emerald tiara and she could use the pendants for drops on earrings and a brooch.

That would give her a second option and the diamonds and emeralds would go well with the red dress (especially for an Italian State Visit).