How to look young, no facelift needed

The actress and mother of three adopted sons, and a spokeswoman for the filler brand Restylane, added: “It’s a far better alternative than having your face cut apart and ending up looking like you got sucked into a wind tunnel.”

Some of this change in attitudes is down to the efforts of Dr Gerald Imber, a pioneer in the field of subtle facelifts and the go-to person in Manhattan for women of a certain age who want to remain . . . looking a certain age. The king of the tweak, master blaster of wrinkles and skilful upholsterer of sagging jawlines has a philosophy of self-help and less invasive surgical procedures performed throughout the thirties, forties and fifties that has helped thousands of women (and men) to age more gracefully.

“Most women don’t want to sit around and wait for ageing to become pronounced enough to need the old-fashioned, too-tight facelift that has given plastic surgery a bad name,“ he says.

We are in his Youth Corridor clinic, on the Upper East Side of Manhattan, where most New York cosmetic surgeons work. Imber, who is in surgical scrubs, has carried out two facelifts this morning, each lasting about two hours, and the reconstruction of a nose lost through cancer. “Oh yes, we’ve got victims all over the place,” he jokes, as we pass the door to the operating suite.

Recognised as being among the top 1 per cent of cosmetic surgeons in the United States, the 74-year-old says most of his clients are women in their fifties. “I like to describe the people I take care of as being more women-who-work than women-who-lunch,” he says. “I have lawyers, psychologists, professors, writers, politicians and people in film and the theatre. They’re some of the most powerful women in the country and what they want is to look as vital on the outside as they feel on the inside.”

Name names, I say. “Absolutely not,” says Imber. “When women come to me they are admitting there’s something they don’t like about their appearance. Their psychological defences are down and my job is to help them, not to trade on their names.” He says he would not tell his globetrotting wife Cathryn Collins, who owns the luxury cashmere label I Pezzi Dipinti, if her best friend came to see him. “It’s a trust that I take very seriously.” All he will say is that he has worked on people in the last six administrations in Washington, has high-level clients in the media and has treated Oscar and Tony-award winners.

Trained as a general surgeon before moving into cosmetic surgery, Imber has shaken up the establishment several times. He was the first doctor in Manhattan to build an operating theatre on his premises. Then he began to question the one-size-fits-all facelift. “I thought we were doing too much surgery. Everybody got the same operation, everybody got their skin pulled. You did the same for a 54-year-old as you did for a 74-year-old and it didn’t make sense to me.”

At the time, he says, there was an attitude in his profession that the early changes in appearance brought about by ageing were not worth dealing with. “I thought that the earlier we became involved, the better. We had to help people to avoid the loosening and wrinkling that becomes severe enough to bring them to surgery because some of those things can never be reversed — or not fully reversed — and still look natural,” he explains.

He developed the limited-incision facelift, also known as the short-scar facelift, a less invasive procedure that has become the gold standard among plastic surgeons. He also popularised microsuction, a refined liposuction that removes jowls and tightens the jawline.

So what is the peculiar-sounding “youth corridor”? “The youth corridor is that time in life when you radiate beauty, health, energy and vitality, when you look and feel your best,” he says. “I believe every woman can remain agelessly in that youth corridor for decades with preventive measures.”

Imber defines this as a programme of prevention, maintenance and correction, claiming that it can help women to stay looking almost exactly the same from 35 to 60. “Not exactly the same but pretty darn close,” he clarifies. “You can walk into a room and see a woman and she is dazzling — she’s not 35 and she doesn’t look 35 — but she’s the greatest-looking 55-year-old she can be. Yes, she has signs that she’s been around the block, but she looks great — her skin fits, she’s got a great haircut and she takes care of her body. That’s the way it should be.”

In his book The Youth Corridor, Imber outlines a checklist of changes women will see on their faces as they age and what they should do about them. Smile lines and fine wrinkles around the eyes, irregular pigmentation, sunspots and dark circles under the eyes can be taken care of with a good skincare routine, which may need to be jump-started by an aesthetician with treatments such as antioxidants, AHA peels and tretinoin, which helps acne and other skin problems.

Deeper smile lines, frown lines on the forehead, lines at the corners of the mouth and wrinkled lower eyelids can be controlled with Botox, Dysport, fillers and peels.

The third group of changes requires various levels of surgical intervention, he claims. It includes hooding of the eyelids, bags or puffiness under the eyes, deep lines around the mouth, double chin, jowls, loss of cheekbone prominence and platysma (vertical bands at the front of the neck). According to Imber, these can be corrected in procedures now considered routine among cosmetic surgeons.

After 35 years in the business, carrying out about 20,000 surgeries, Imber will launch his first skincare range in September at Harrods. He developed creams for healing and maintenance a few years ago and sold them to patients. “Someone from Harrods got hold of some and loved it and asked where she could get more, and when I said it wasn’t for general sale, it all took off from there,” he says.

There are eight products in the range but the three main ones — the Ultimate Antioxidant C Boost Serum, which claims to fends off damage, the RetinUltimate Transforming Gel, which allegedly rejuvenates the skin and the Ultimate Nourishing Creme moisturiser — bought together retail for an eye-watering £850.

Does he think the prices are extremely expensive? “If you can’t afford the whole range, buy the hero product,” he advises, referring to the Ultimate Antioxidant C Boost Serum, which costs £200 and lasts six to ten weeks. He talks enthusiastically about the antioxidants vitamins C and E that are combined with melatonin and vitamin B3 in this supercharged liquid. “Everyone sees a difference in their skin within ten days. I think a lot of women would pay £200 for that,” he says.

There used to be a yawning gap between British and American women and their attitudes to cosmetic surgery. American women embraced it too enthusiastically, he says, while British women were conservative. Now they are closer.

“British women are still not fully aware of the value of treatments such as fat transfer and microsuction and tend to come a little later to the idea of a facelift because they wrongly think the only facelift is a big ol’ facelift,” he says. “Everybody wants to look natural. The key thing is not to wait until you’re unhappy with what you see in the mirror. Even if you aren’t convinced of the wisdom of doing small procedures earlier, there’s absolutely no excuse for not following a self-help routine.”

I am not going to waste a free consultation with one of America’s top cosmetic surgeons so I ask Imber to cast a professional eye over my 56-year-old face. I have tried laser therapy once, and loved it, but have had no other work done. He tells me I could have a light touch of Botox around my eyes, a fat transfer to fill out the lines around my mouth and microsuction to address “laxity” in my lower neck. The cost would be about $8,000 (£5,000). Though I don’t need it — yet — a short-scar facelift would be about $20,000 (£12,000).

It is a lot. Not something to rush into, Imber agrees. “If women follow a good skincare routine and make little changes at the right times, they might keep on looking great and never need a facelift,” he says.

He says he has had “zillions” of British clients over the years. “Just the other day, a woman came over from the UK for a consultation and said she had always been regarded as the prettiest banker in the City, but age was catching up with her and she wanted to know what she could do to avoid having a facelift.” She went away with fillers and will come back for a surgical procedure.

Many of his British clients are in fashion or the media, Imber adds: “When I go to Claridges, I invariably meet women I know, and they look fabulous, and that is very gratifying.” Of course, he never acknowledges just how he knows them.