Zap those wrinkles before they appear, advises Dr Gerald Imber. But will women fall for 'preventive' cosmetic surgery? Report by Hester Lacey
In your early thirties and saving for a holiday, a car, a house? Perhaps you should think about adding a facelift to the list. A new book that is taking America by storm suggests that a programme of "minor" cosmetic surgery, begun early (no, 30 is not too young) could preserve youthful looks and help avoid a major nip-tuck-and-slurp in the scraggy, saggy, jowly fifties.

The title The Youth Corridor, by Dr Gerald Imber, a New York plastic surgeon, refers to the years from 30 to 55. Dr Imber believes that it is possible to "remain largely unchanged by the stigmata of age" during these vital years. Speaking from his office on Manhattan's swanky Fifth Avenue, the genial Dr Imber (56) is thrilled by the stir his book has caused. "The shows we have been on have been asking us to stay for double the time booked. We went on the Today show twice, that's unheard of for a book launch. We have sold in excess of 25,000 copies in two weeks."

He believes this is because "you cannot argue with the common-sense of the book. For someone in their thirties, surgery is minor, and it will forestall later major surgery." Dr Imber has treated a number of stars over the years (he won't say who) and his methods are the very ones used to keep their famous eyes and cheeks twinkly and taut. "People in the public eye need to keep their image up - they can't wait till they are 63 for a complete overhaul. So I developed techniques to achieve that. At the same time there have been great developments in skincare that really work. There's nothing I know that other plastic surgeons don't," he adds modestly, "I've just put the techniques together." Though in fact, he is a pioneer of two procedures: he developed microsuction (a very slender needle inserted behind the ear and wiggled along the jaw to slurp away fatty jowls) and has popularised the "S-lift" (a form of facelift a few degrees less drastic than going the whole hog).

Dr Imber just loves being a plastic surgeon. "It's a happy profession," he says. "You get a smile and a thank-you from all your patients. It's instant gratification, and it's very artistic - far from pain and pills. I can't think of anything else I'd rather do." Far from pain? Surely he must hear the odd "ouch"? Firmly he says that discomfort is "minimal".

And he is at pains to point out that, despite the artistic gratification of the scalpel and needle, his book also contains sound beauty and diet hints. Wash your face with soap and water, eat well, don't gain and lose weight, don't smoke, exercise - "a young person can learn all this and may not even need me," he says. "If you took the chapters on plastic surgery and threw them in the garbage, the person that would do best with the book is a 19-year-old girl."

Anyone who has not followed the Imber path from the age of 19, however, might need to follow in the footsteps of "Victoria", one of the Youth Corridor's hypothetical case histories. Victoria is 32. She is 5ft 6in, weighs eight-and-a-half stone, skis, plays tennis, and does aerobics. Should she feel righteously smug about her enviable face and figure? Nope, because, horror, she has recently noticed "a few smile lines around her eyes". She should book in right away to have her corrugator muscles divided (via small incisions in the natural folds of the upper eyelids - cost, $1,000 upwards). The existing furrow can be filled in with fat transplants.

Then Victoria should go for laser resurfacing treatment on the smile lines developing on her cheeks beside the eyes (again, $1,000 upwards), and a series of six concentrated alpha hydroxy acid treatments to undo accumulated sun damage on her fair skin ("fees are fairly modest - between $100 and $300 a session"). She may comfort herself with the notion that a full face-lift would cost $7,000 to $10,000; and she will also recoup some of the costs by giving up her aerobics class, as Dr Imber does not recommend high-impact exercise for anyone over the age of 30 (hip hooray).

All the techniques described in The Youth Corridor are available in Britain; but British women do not rush to book in when the first fine lines appear. And Tim Milward, consultant plastic surgeon at Leicester Royal Infirmary, and member of the British Association of Plastic Surgeons, is unconvinced by the "little-and-often" theory. "The one obvious benefit of all this is to this doctor's bank balance," he observes. "What he is doing is locking women into a long string of relatively pricey treatments. I would only offer treatment if there was something to be treated - and if the treatment was likely to resolve the problem. I tell my clients not to have a face- lift until they need one, as the results are so unquantifiable."

Dr Imber's ideas also gets short shrift from the Surgical Advisory Service, an advice line for those considering plastic surgery. "In your thirties we don't advocate surgery," says the SAS's Jackie Sullivan. "The emphasis should be on maintaining a good diet, exercising, using sunblock. Do these things and you will look good. Running repairs are not needed until the mid-to-late forties. The Americans are very critical - they want everyone to conform to a very standardised ideal of beauty. In this country we're not like that."

But are we? Offered a relatively cheap operation without too much "discomfort" that would keep you looking 30 until you were within spitting distance of drawing your pension ... well, would you? No, says novelist Joanna Briscoe, 34, who observed several cosmetic operations to research her novel Skin (Phoenix pounds 16.99). "I wouldn't on principle; we are being told that ageing is like a disease, and it isn't. This fear of ageing is being spread earlier and earlier, but it's just hysteria. Aesthetically it would be ridiculous at my age. And I don't believe that procedures like laser treatment are minor. I saw a woman having this operation and she was crying out and rolling her head round in pain. She looked like a burn victim afterwards - her dog didn't recognise her. And many of these procedures are still experimental - we don't know what the long-term effects are." She adds that plastic surgeons are mostly male and middle-aged and have left their faces exactly as nature intended (Dr Imber falls into this category). "They nearly always say they wouldn't have any cosmetic operation themselves. If one suggested to me that I needed an operation, I'd tell him where to go."

But the notion is tempting to others. Sandra Law, 33, works in marketing. "I'd consider a few thousand pounds a very reasonable investment to stay as I am for the next 20 years. It's everyone's dream to keep their looks - look how everyone is jealous of people like Mia Farrow, who naturally look younger than they are. I'd even be prepared to suffer a bit."

"I've never seen the point of getting old then suddenly reappearing with this radically different, stretched-out old face, but the idea of preserving what you have is very attractive," says Karren Stacey, 31, office manager.

Dr Imber would be glad to hear it. "I can't believe that British women are less interested in their looks than American women," he says. "I think there are very few people who genuinely don't care about their looks. I would love to publish in Britain." And will there be a companion volume? "My next book will be specifically geared at men."