Up to the 5th century BC , the head was shown as being very ugly , with her tongue sticking out , boar tusks , puffy cheeks , her eyeballs staring straight ahead and the snakes twisting all around her . Up to the 5th century BC , the head was depicted as particularly ugly , with a protruding tongue , boar tusks , puffy cheeks , her eyeballs staring fixedly on the viewer and the snakes twisting all around her .