The ultimate extension of the ruffs, or wide pleated collars, that were so popular among the wealthy in the sixteenth century was the Medici collar. A Medici collar provided a large, decorative frame around the sides and back of a woman's head. The collar was typically worn with a gown with a décolleté neckline, a low neckline that revealed a woman's cleavage. Supported by wire or heavy starch, these collars of lace, embroidered satin, or some other light material could reach great heights, towering over the shoulders and head of the wearer. They might be studded with tiny jewels and could be worn with a normal ruff if desired.

The Medici collar was introduced and named after Catherine de Médicis, who was Queen of France from 1560 to 1574. The collar may be most associated, however, with Elizabeth I of England (1533–1603), whose great flair for dramatic clothing styles made her the fashion trend-setter of the century. Medici collars have remained in use up to the present day, though they are now worn only in pageants or shows.

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