Actress turned wellbeing guru Gwyneth Paltrow is probably best known for treatments that aren't – ahem – confined to her face. But now the woman who brought us jade eggs and vaginal steaming is happily promoting injectable anti-wrinkle tweakments on Instagram.
Unveiling a make-up free face, complete with broad smile, a tiny smattering of crow's feet, but, crucially, no frown lines, she gushed about her experience with the prescription-only Botox-like treatment, Xeomin, saying that smoothing out the "elevens" between her brows helps her look "less p***** off".
Dealing with ageing, the 48-year-old star told Harper's Bazaar last week, is "a multi-layered experience". And "sometimes a girl needs a little extra help".
I'm certainly not going judge her for that. My desk at home doubles as my dressing table, so there's a magnifying mirror by my laptop. Over the last year, I have watched my own frown lines, usually kept at bay by six-monthly doses of baby Botox – firmly etch themselves into my skin.
I'm far from alone in feeling that the pandemic has aged me. An estimated six million of us believe that lockdown has left us looking "at least" five years older, according to research commissioned by UK cosmetic treatment firm Uvence.
Meanwhile, another survey by non-surgical cosmetic treatments digital marketplace Glowday found that 43 per cent of women would now consider an aesthetic, or non-surgical treatment, as a result.
The most popular options under consideration were Botox, fillers, threads, microneedling or peels.
But are these the best way to dip your toe into the rejuvenation business if you are a woman in mid-life? Certainly, the overstuffed lips and Mount Rushmore cheekbones of the reality TV crowd are even more grotesque on a woman over 40.
And even the most benign-seeming, temporary tweakments can go very wrong. I've written about cosmetic procedures for decades and have been trying them for the same length of time.
Some years ago, I had Botox injections to smooth out my rumpled forehead. The result? My brows and eyelids dropped like shutters. My doctor failed to realise that my forehead lines were due to my lifting my brows to take the weight off my genetically hooded eyes.
I've also had a new treatment that uses sparks of intense heat to supposedly lift my eyelids. It was painful, caused massive swelling and scabbing and, to add insult to injury, left my eyes looking no better.
Even Paltrow herself admits that she has suffered from cosmetic catastrophes like mine: "I had a midlife crisis when I turned 40, and I went to go see this doctor. It was a disaster," she said. "I didn't do anything else for a long, long time. I was bruised, my forehead was completely frozen, and I didn't look like myself at all."
So, what changed her mind? Well, these days, doctors are a lot less heavy-handed than they used to be. Dr Mervyn Patterson, founder and medical director of Woodford Medical Clinics, says that during the last year, his midlife patients have been particularly insistent that any treatment they have will make them look better, yet be undetectable, especially to their husbands.
"They tell their husbands they are going for a facial or maybe some microneedling – a treatment using tiny spikes in the skin to produce more collagen – if they need to explain the odd tiny bruise," he says. "I'm very happy with this less-is-more approach. Subtle is always best."
Patterson says that as we age, localised fillers or Botox rarely give great results on their own. You might be tempted to zero in on, say, crow's feet or jowls, but he says: "Ageing and sun damage affect the whole face, so you can't treat just one area. Instead, I use tiny amounts of filler over the whole face.
"With Botox, if I treat the frown lines, I also inject the nose as otherwise you end up with 'bunny lines' that appear every time to try to frown. If I treat crow's feet, I taper it gently otherwise you end up with static areas around the eye when you smile, but then either lines or even a lumpy effect where the face still has movement."
A problem with inexperienced practitioners, he says, is that they can create an effect that looks impressive when patients are looking into the mirror with an expressionless face, but unnatural when the same face is animated: "Sometimes women catch sight of themselves laughing or see a photograph and it's the first time they realise how odd they look."
But, like Paltrow – who said: "I think it's nice when women share, because there's a lot of shame around surgery or injectables or fillers" – an increasing number of fresh-faced celebrity midlifers are happy to admit to a little light tinkering, with mostly enviable results.
Judy Murray, 61, recently unveiled the effectiveness of the Obagi Nu Derm medical skincare system in reversing sun damage alongside £4500 (NZ$8746) micro-needling treatment and radio frequency treatment called Morpheus8.
Dr Dev Patel, aesthetic doctor and founder of Perfect Skin Solutions, says: "Morpheus8 results take a few months to manifest but you end up with new collagen and elastin. Many women in their 40s develop a sagging chin/jawline. Two to three sessions of Morpheus8 can restore some of the youthful architecture back to the skin."
Needling is a relatively easy, low-risk, low downtime skin booster. Victoria Beckham, 46, has openly talked about going for SkinPen sessions, which combine needling with skincare.
Profhilo, a form of "injectable moisturiser" made with the same water-binding hyaluronic acid used in fillers, is another popular choice for those who want to look more rested. It won't erase wrinkles or alter features but will make skin look dewier.
Fillers proper can become tricky in midlife. Nobody wants a trout pout. However, it's true that most of the changes in facial structure come from loss of volume. Fat, collagen and even our skull bones start to disappear as we age.
Trying to restore girlishly plump cheeks only leads to tragic results. Instead, doctors are increasingly using filler around the "frame" of the face to subtly lift loose skin and firm up jawlines for a face that looks better without compromising your dignity.
One of the most effective uses of fillers I've personally experienced was when Dr Sarah Tonks of The Lovely Clinic announced, to my surprise, that I could benefit from filler in the hollows at my temples, above the ear. By painlessly popping a small amount of HA based filler here, as well as at my jawline and sides of my cheeks, she lifted the tail of my brows, smoothed crow's feet and framed my eyes better.
For a more drastic improvement, Patterson is also an advocate of PDO threads – which are tiny dissolvable threads which, sewn under the skin, help support sagging skin and build collagen, with results lasting about a year. The procedure looks terrifying – actress Eva Mendes, 47, posted a picture of herself having threads to tighten her enviable jawline – but is less painful than it looks.
Whatever treatment you opt for, the key to looking great as you age – and by that I don't necessarily mean looking younger – is to have great skin. This can be achieved via devotion to a good skincare routine and daily sunscreen. Patterson recommends Epionce medical skincare, which is particularly suitable for sensitive skin.
A few years ago, I underwent a radical skin overhaul using the Obagi Nu Derm system myself, under the supervision of Dr Mayoni Goonerate of The Clinic. The products contain glycolic acid, vitamin C and prescription vitamin A to peel away old skin and generate fresher, brighter skin over around three months. It's drastic – expect some redness and peeling – and pricey, but I was astonished by the results. Not only was my skin clearer and glowier, it looked firmer and tighter too.
I'd always advise anyone dipping a cautious midlife toe into the world of tweakments to stick with minimally invasive ones that have been around a long time so you know they are safe, and to start small. As for me, I've not had a single treatment for well over a year. This has given me a chance to think about what really works for me.
Having the time to spend on my skin means that I'm pretty happy with that, but like Gwyneth, I will be booking in for the tiniest sprinkle of Botox between my brows. After all, come the end of lockdown, when we are finally able to have some fun, I want to look as cheerful as I'm going to feel.