Medical advances are making the 'mini-facelift' an increasingly popular and considerably cheaper alternative to full-scale cosmetic surgery. And the clients are getting younger. Roger Dobson and David Randall report

The face of Britain is changing. More and more younger people - most of them women - are having cosmetic surgery, and the average age of patients has fallen so sharply that more than 85 per cent are aged under 50.

The face of Britain is changing. More and more younger people - most of them women - are having cosmetic surgery, and the average age of patients has fallen so sharply that more than 85 per cent are aged under 50.

Nowadays, say leading surgeons, the typical client is more likely to be a 30-something trying to keep his or her looks than a 50-something trying to salvage them. And spurring on this trend is a new "mini-facelift" that can be done under local anaesthetic.

Favoured by professionals from their mid-30s who want an "edge" in the career race, the surgery, which has been available in the UK only for the past 18 months, is less extensive - and cheaper - than the traditional full-facelift, which can cost up to £12,000. Surgeons say there has been a fourfold increase in women and men having the £3,000 operation, and it is now Britain's fastest-growing cosmetic surgical procedure.

LeRoux Fourie, a consultant plastic surgeon at Methley Park Hospital near Leeds, run by the private health company Bupa, and at Pinderfields Hospital, Wakefield, said: "It is a facelift for the 35- to 50-year-olds. Recovery is quicker, the scar is well hidden, the chances of complications are less, and they can still have a traditional facelift when they are older. We have now done more than 50 in less than a year, and patients like it because they can get back to work very quickly. Until now, patients thought they had to wait until they were older and their face really sagged.''

The mini-facelift, or the minimal access cranial suspension operation, as it is known in this increasingly busy trade, was first developed in 2002 in Belgium. Mr Fourie explains: "It involves just two cuts, one in the hairline and one in front of the ear. Two or three stitches are put under the skin that grab the layer above the muscles. The stitches are pulled tight and that elevates the jowl area and tightens everything. About one in six of the people we have done are men - the advantage for men is that the scars are well hidden. With a traditional facelift, the hairline goes higher and that can be a problem for men.''

Now it is not just people like the Italian Prime Minister, Silvio Berlusconi, who are having facelifts. Bupa's new figures show a 31 per cent increase in facelifts in the past 12 months. Over the same period, there was a 27 per cent increase in breast augmentations, for which the average age of clients has now fallen to 32. This has become the nation's most popular cosmetic surgery; only Finnish women have more operations to enlarge their breasts. The British Association of Aesthetic Plastic Surgeons reports that breast ops make up one in five of the 10,700 procedures reported last year by its 160 members. In second place is eyelid surgery, followed by face and necklifts, liposuction and nose jobs.

One in 12 cosmetic surgery patients were men. For them, the most popular operation was to pin back ears, followed by nose surgery, eyelids, facelifts and liposuction.

Fast, routine procedures such as the mini-facelift mean that cosmetic surgery is now moving away from the image portrayed in television dramas like SkyTV's Nip/Tuck. Here, in obviously top-dollar surroundings, vulnerable clients have to cope with advances from predators like Dr Christian Troy in order to have operations of Frankenstein-like complexity. The reality, with the advent of the facelift you can have in your lunchbreak, is that cosmetic procedures are becoming both commonplace and affordable.

Britons now spend more than £200m a year on cosmetic surgery, four times the level of a decade ago. It is one of the most common reasons given by women applying for non-property loans. The new facelifts also carry less risk than more invasive operations. Last year, Denise Hendry, wife of the footballer Colin Hendry, nearly died after cosmetic surgery, recovering only after emerging from a prolonged coma. And last week, Olivia Goldsmith, best-selling US author of the novel The First Wives' Club, died after a bad reaction to anaesthetic for a facelift.

But no procedure that interferes with the natural process of maturing is foolproof, as the actress Leslie Ash discovered when cosmetic surgery left her with a mouth that bore more resemblance to Mick Jagger's than the one she started with. Although the resulting "trout pout", as it cruelly became known, has been mitigated by further surgery, the criticism she attracted at the time showed the stigma that attaches to celebrities who attempt to improve on nature.

The American comedian Joan Rivers is regularly mocked for a face that appears to have been made rigid by repeated lifts. The film actor Mickey Rourke has similarly suffered criticism for a chin implant he has allegedly had. According to the website Awfulplasticsurgery.com, one leading lady has been left with a face "so tight it looks like a kabuki mask". Small surprise, then, that other celebrities who seem to defy ageing, such as Sir Cliff Richard, are reluctant to admit to having had surgery.

Hollywood surgeon Dr Richard Fleming even reports a star who, a few months after remodelling, was beaming on magazine covers claiming that her youthful appearance was all down to yoghurt and clean living. As he says: "Hollywood will accept you with two faces, but not two chins."

God forbid, but it seems that Britain is going the same way.

Case study: 'A few days later I went out shopping'

June Tate, 39, a nursing sister from Wakefield in West Yorkshire, is among those who have had the mini-facelift. She was impressed with the result.

I had my eyelids done at the same time, and I was out of hospital the day after. A few days later I was shopping - it was quite incredible.

Immediately afterwards my face felt very swollen, and everything seemed very tight. But it was very much worth it.

One of the first things I noticed was that my skin texture was a lot smoother. The saggy bits, the jowls, had also gone, and I looked younger.

When the bandages came off the day after, I thought I had gone too far because I looked like a teenager. When I looked in the mirror it took me back to being a child again. Then the swellings went down, and people say I look about 30. These days when I look in the mirror, I am very happy with the results.

A nose like Nicole's

Clients regularly walk into the Hollywood clinic of the well-known cosmetic surgeons Dr Richard Fleming and Dr Toby Mayer and ask for part of their face or body to be made over to resemble a particular celebrity's. Six years ago the two surgeons started compiling a list of "star" body parts most requested by patients. If ever proof were needed that this business is a creature of fashion, then the 2003 "Hollywood's Hottest Looks" list is it.

Most requested features (women)

Nose: Nicole Kidman, Reese Witherspoon, Diane Lane

Hair: Jennifer Aniston, Debra Messing, Sarah Jessica Parker Eyes: Halle Berry, J-Lo, Cameron Diaz

Lips: Liv Tyler, Uma Thurman, Renée Zellweger

Jawline/Chin: Salma Hayek, Julianne Moore, Kim Cattrall

Cheeks: J-Lo, Halle Berry, Jennifer Garner

Sculpting: Angelina Jolie, Britney Spears, J-Lo

Skin: Michelle Pfeiffer, Gwyneth Paltrow, Sandra Bullock

Most requested features (men)

Nose: Ben Affleck, Edward Burns, Jude Law

Hair: Pierce Brosnan, Richard Gere, Hugh Grant

Jawline: Johnny Depp, Matthew McConaughey

Lips: Brad Pitt, Matt Damon, Benicio Del Toro

Eyes: Brad Pitt, Ralph Fiennes

Cheeks: Leonardo DiCaprio, George Clooney, John Corbett

Chin: Russell Crowe, Kiefer Sutherland, Matt LeBlanc

Sculpting: Tom Cruise, Benjamin Bratt, Matt Damon

Skin: Ethan Hawke, Hayden Christensen, Ryan Phillippe

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