A step too far?

Perhaps one of the most unsettling developments in the modern-day beauty industry is the increase in the number of celebrities – and members of the more common herd – who are willing to have surgery and other medical procedures to enhance their appearance and prevent the signs of ageing.

In the past, people hid the fact that they had had some form of cosmetic surgery. A major exception was the comedian Fanny Brice, a headliner in the first half of the 20th century best known today for Barbra Streisand's portrayal of her in the musical Funny Girl. However, Brice's bravery in admitting to a nose job was forgotten among accusations that she was trying to disguise her Jewishness – 'She cut off her nose to spite her race,' someone quipped.

These days, relatively radical changes to the appearance of the face can be achieved without a knife in sight. The availability of instant treatments such as 'Botox' and collagen lip implants has led to a nonchalant attitude towards facial alteration.

In 'Botox', tiny amounts of the toxin produced by the bacterium Clostridium botulinum (a little more of which would lead to the fatal condition botulism) are injected into the face. This paralyses muscle tissue and so eliminates 'ageing' lines. So popular is this technique that 'Botox parties' are becoming increasingly common. Such is the instantaneous effect of the treatment that groups of women – and men – can be attended to by a cosmetic surgeon in the space of an evening, while enjoying a bottle of wine with friends.

Some beauty pundits believe that the way forward is to eliminate the stigma of having plastic surgery. 'All make-up highlights your best assets. What's the problem with having it surgically done?' they ask. Others strongly disagree. 'If anyone mentions to me that they might be considering plastic surgery, I have only two things to say: "Michael" and "Jackson",' says writer Kathy Lette.