Lewis Wolpert - You’re Looking Very Well

Despite people’s professed opinions, however, cosmetic surgery in general has been growing in popularity in Britain, with a threefold increase in the first decade of the twenty-first century. According to figures released by the British Association of Aesthetic Plastic Surgeons, only 10,700 procedures were performed in 2003, but by 2009, this figure had risen to 36,482. One of the biggest growth areas was in people in middle or late middle age. These figures do not include non-surgical interventions like the use of Botox, which has been increasing even more rapidly. The most common procedures were breast enlargement, liposuction, and eyelid and facial surgery.

In the US, over 10 million surgical and non-surgical procedures were performed in 2008, costing over $11.8 billion. Men had over 800,000 cosmetic procedures. Strikingly, people aged between 54 and 61 had about a quarter of these procedures, and people over 65 much fewer. Over half were for breast augmentation and fat reduction. Plastic surgery of the face can help you feel better, but does not affect what is going on inside the body. Anti-ageing surgery procedures are widely advertised on the internet with the injunction to ‘Get expert free advice’. These include Eye Bag Removal, which can restore a youthful look through the removal of fat and excess skin from both sets of eyelids, and the Brow Lift is a procedure that concentrates on restoration in the upper part of the face, correcting drooping eyebrows and loose skin in that area. Facelift surgery challenges the most visible signs of the ageing process: loose facial and neck skin is removed to produce a smoother, fresher appearance. The operation can take between two and three hours and it is recommended that patients spend at least one night in the cosmetic surgery clinic after the procedure. Liposuction entails the removal of fatty deposits from any part of the body, a process usually taking no more than one and a half hours to complete. The recovery time involved is minimal, with most patients getting on with their lives again within a few days.

Those undergoing or planning to undergo cosmetic surgery still constitute a distinct minority, but the numbers would increase if it could be done safely. As with any surgery, there are some risks associated with these procedures. And not every procedure will have the desired results, as the case of the unfortunate American Jocelyn Wildenstein, who allegedly spent $4 million on facial plastic surgery to please her husband, illustrates. She has been unkindly dubbed ‘The Bride of Wildenstein’, and her horrified husband apparently commented, ‘She seems to think you can fix a face the same way you fix a house.’ But the emotional benefits of plastic surgery results can be many times greater than the physical rewards. If you have felt bad about the way you look, plastic surgery can make you feel better about yourself.

Treatment based on Botox injections is probably the most popular cosmetic surgery worldwide. The adverts refer to the frown lines, crow’s feet and wrinkles around the mouth that can cause a person to look worn out, tired and old. Botox treatments were first approved by the FDA in 1990 for the treatment of eye muscle spasms for those under 65; however, its cosmetic value was quickly realised. Botox cosmetic is an approved trade name for botulinum toxin, produced by the bacterium Clostridium botulinum . When injected in small doses in designated areas, Botox blocks nerves activating muscles responsible for the repetitive action that causes fine lines and wrinkles, and literally paralyses the area. Normal Botox treatment with a doctor will cost about £ 400, and results can last up to eight months. But it doesn’t always, of course, have the desired effect, and can lead to a face that looks angry as well as to headaches. One actress claimed that it made her look like an extra from the Planet of the Apes .

A multitude of wrinkle creams and lotions sold in chemists and department stores promise to reduce wrinkles and prevent or reverse damage caused by the sun. At the top end of the market, Oro Gold Cosmetics has introduced a set of anti-ageing products (including eye serums, bionic facial treatment and skin moisturisers and other products) infused with 24k gold—which, they claim, but without reliable evidence, has many properties that induce rejuvenation in the skin. But do any of these products actually work? Some research suggests that wrinkle creams do have ingredients that may diminish wrinkles. But according to Mayo Clinic physicians, many of these ingredients have not undergone scientific research to prove their benefit. Creams and lotions may slightly improve the look of your skin, depending on how long you use the product and the type and amount of the active ingredient, but any effects from non-prescription wrinkle creams will not last very long. You’ll have to dab on wrinkle creams once or twice a day for many weeks before noticing any improvement. And once you stop, your skin will very likely return to its original wrinkled appearance, according to dermatologists. Studies have confirmed that more expensive wrinkle face creams work no better than cheaper products.

Which? magazine decided to put anti-ageing creams to the test. It selected 12 ordinary moisturisers and 12 anti-ageing creams. Groups of four women tested each product for four weeks. None of the 96 women knew which product they were using and at the end of the trial they were asked to guess whether they had been using a moisturiser or an anti-ageing cream. Three quarters chose moisturiser. Most had not noticed any difference in the look or feel of their skin, and of the 48 women who had been using an anti-ageing cream, only 10 reported any improvement.

Which? concluded that ‘some of the claims made for the ingredients of anti-ageing creams can be substantiated but, with the low concentrations used in the creams, they are unlikely to do more than moisturise your skin’. There is more support for this view from a beauty-industry insider: ‘There is no miracle ingredient that will take years off your appearance,’ says Gisele Mir, a cosmetic scientist and founder of the holistic skincare range Mir. ‘The only miracle is that the cosmetics industry has managed to persuade us otherwise for so long. In my opinion you can harm your skin by using anti-ageing products. I believe many of these products accelerate ageing rather than prevent it.’ Tretinoin, a derivative of vitamin A, is the only topical medication that has been proven to improve wrinkles.

The advertisements and publicity seem endless. A full-page advertisement in several UK newspapers proclaims: ‘Is your skin ageing too fast? Our scientists definitely think so… Inspired by 25 years of groundbreaking DNA research, Estée Lauder now innovates anti-ageing skincare…’ In the US: ‘Discover the FIVE SECRET RITUALS from a Hidden Himalayan Monastery that Make You Look 30 Years Younger—In Just 10 MINUTES A DAY! $39. This unique complex of Bio Enhanced trans-resveratrol and potent polyphenols and anthocyanins is formulated specifically to fight ageing at both the genetic and metabolic level.’ It is claimed that CoverGirl Simply Ageless Foundation significantly improves skin condition in just four weeks, and super model Christie Brinkley’s affiliation with CoverGirl was a huge success. She said: ‘CoverGirl is part of my DNA and I’m thrilled to be back with my family. I’m excited to promote a new product developed specifically for women like me, who want flawless coverage combined with the latest science in skincare. I’m looking forward to working with the brand at a time when there is so much innovation.’ But there is as little real evidence for the benefits of agents that prevent facial ageing as there is for medical treatments.

In April 2009 there was a report that a new product from the chemist Boots, which works by stimulating the production of a protein that promotes skin elasticity, made a significant difference to the wrinkles of 70 per cent of volunteers aged between 45 and 80. This was a properly conducted trial by the University of Manchester and so seems an important advance. It led to a stampede to Boots’ shops which is still continuing. In one month, February 2010, Boots sold more than 700,000 anti-ageing creams. However, other experts say that only one in five users will get something more than from using common moisturisers. A new product of a quite different nature is a device that electrically stimulates the muscles in the face; there are claims that it is safer and more effective than plastic surgery, and acts due to stimulation of the facial muscles, but there are no reports of proper trials.