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God fucking damn, Okiura.
This is the equivalent of Shingo Yamashita having the Pain face on his resume. And I like both Okiura and Yamashita.

There's a chance that he intentionally deformed her face, but if he was just going for the stressed version of Motoko's on-model face, the wrinkles he added were disproportionately strong compared to the standard GitS art style and the lips are stretched not by natural muscular tension, but as if an invisible set of dentures were leaving her mouth. http://i.imgur.com/9gIhcdl.png

Those wrinkles are accurately and realistically positioned, but using a bold black line for them implies a wrinkle way deeper than http://i.imgur.com/JO7sL0F.jpg this face is designed for. The less detailed a face is in its neutral state, the stronger the effect of each line drawn onto it.
If he wanted to imply wrinkles on a simplified anime face without magically aging her, there's always this technique: http://i.imgur.com/QSICpZ9.jpg to imply waviness in the skin via shading.
http://i.imgur.com/GdIzc6y.png
http://i.imgur.com/I76RlMQ.png
Here are some examples off the top of my head of how this shading's fundamental properties can successfully depict a youthful-but-stretching face.

A difference in lighting and a bold black line imply very different spatial information to the viewer.

Backtracking: if Okiura wanted to make her ugly, he succeeded in my eyes. If he wanted that sort of natural, in-the-middle-of-combat "ugliness," then nah. He's still a boss, though.