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They've had the tummy tuck, chin-tightening, Botox jabs, face and bottom lifts, but, to the appearance-obsessed, those scrawny, tell-tale fingers will give away their true age.
But now, help is at hand - cosmetic surgery has finally reached the ends of the arms.
Hand rejuvenation is the new
must-have procedure.
These "hand-lifts" are achieved by one of two methods: either fat transfer from elsewhere in the body or mesotherapy, injecting cosmetic fillers similar to those used on the face.
Wrinkled, bony hands with prominent veins and deep grooves suddenly become plump and healthy looking.
Simon Withey, a consultant plastic surgeon at London Plastic Surgery Associates (LPSA), said demand for the little-known procedure had picked up by between 300 and 400 per cent over the last three years, with his clinic now conducting at least one hand-lift a week.
"Hand rejuvenation is not something that is really in the public eye, but more and more people are requesting it," said Mr Withey.
"A lot of them are afraid that their hands give away their age, particularly if they've had other work done.
"You notice your hands almost as much as your face, of course. Whether you're greeting people or expressing yourself, they're always on display. A common complaint is that they are starting to look a bit like deflated balloons - as the skin loses its elasticity and some of the fatty tissue underneath, you get this slightly sunken, wrinkled look between the bones."
The complaint is a common one, particularly among women.
Celebrities including Madonna, Teri Hatcher and Cameron Diaz have all attracted criticism for the ageing, veiny appearance of their hands, which are seen, rightly or wrongly, to detract from their beauty.
Manufacturers of specialist hand rejuvenation injectables are also reporting a rise in demand.
Q-Med, which makes one of the most commonly used brands, Restylane Vital, has reported a 40 per cent increase in sales of the product this year - twice the growth rate of last year.
The procedure itself, which costs in the region of £400 ($1100), is surprisingly simple.
According to Dr Lucy Glancey of Glancey Medical Associates, a string of clinics across the country, hand-lifts with injectable fillers need three sessions of five to 10 minutes over six weeks.
At each session, the patient has 25-30 injections in the back of each hand.
"Quite often, sun damage is an issue, because we usually remember to put sunblock on our faces, but not always our hands," said Dr Glancey.
"On average, every third or fourth person who comes into our clinics will inquire about hand rejuvenation now."The overwhelming majority of these patients are female, she added.
"Increasingly, it is women who are noticing in photographs of themselves that their hands don't match their face," said Dr Glancey.
"Men have a thicker skin, that's due to their hormones, particularly testosterone, and thicker hair which protects them."
Lindsay Stewart, 46, a marketing executive from Hazlemere, Buckinghamshire, recently underwent hand rejuvenation and said it was the best decision she'd ever made.
"I take after my dad, who is Scottish and calls himself a 'peely-wally' because he has incredibly white skin that burns easily," said Ms Stewart.
"I'd begun to notice that my hands looked a lot older than my face. The skin was looking thin and crepe-like, with more veins showing and I felt incredibly self-conscious about them. They looked like old ladies' hands.
"Now I feel incredibly confident. You won't hear me complaining about my hands any more: now I'll be whingeing about something else - like my eye bags."
- INDEPENDENT
