There are several ways to view plastic surgery right now: a 21st-century form of sculpture, an insidious tool of homogenisation, a signifier of advanced social status or simply a way of making your life better. Whatever your take, whatever your ethics, the fact is that cosmetic surgery and treatments are becoming more socially acceptable. According to the British Association of Aesthetic Plastic Surgeons, the number of procedures undertaken rose by 60% in 2004, when a total of 15,019 women underwent surgery in Britain.

Such is our fascination with plastic surgery, it has spawned its own subcultures: the pornography of surgery television, including Nip/Tuck. The Swan and Extreme Makeover; and surgery skincare, a whole new universe of surgery-mimicking beauty products that aim to augment and plump like never before.

Plastic surgery and cosmetic procedures such as Botox are spreading like a virus. It is a peer-group thing, gaining momentum through recommendation and rumour rather than marketing and ads. Friends tell friends, they offer advice on who to go to, then compare pain levels and results. Yet, despite all the media coverage and debate, the world of the surgeon is still closed, mysterious, codified. Operations and procedures carry their own levels of trauma, and debriefing your friends can provide a special kind of emotional anaesthetic.

It's no news that there is good and bad surgery. That's why we have put together this definitive guide. The best of the best, if you like. The surgeons and doctors who will really improve your body and your face. What to do after you've seen them. How to prepare for hospital. How to heal. We've removed the uncertainty, so you don't have to listen to rumours, watch the celebs or book someone you've seen on TV. After all, if you're going to turn yourself into a work of art, make sure it's Michelangelo wielding the scalpel.

There is no such thing as the perfect face-lift, as there is such a variety of techniques in use today. A deep face-lift tightens muscles all the way down through the underlying tissues, then fatty tissues under the neck are suctioned away. Other procedures allow the surgeon to remove skin and lift and elevate the muscles through small incisions made around the ear. Some of the less invasive methods are more innovative in the positioning of the scars - for instance, the surgeon makes an incision behind the ear, then into the hairline, which is perfect for women who wear their hair up.

Time To Heal: Three weeks, depending on the method used.

Risk Factors: Blood clots, numbness, tightness, asymmetry, thickened or raised scars, infection, delayed healing and nerve injury are all possible complications.

How Long It Lasts: The results of the surgery are permanent. You will always look younger for having had a face-lift, although the ageing process marches on, and you can expect to need another one in 5-10 years as the jawline starts to sag again.

Costs: A face-lift in London ranges from £6,000 to £8,000, excluding hospital costs and anaesthetist. In many clinics, this includes eye surgery.

Optimum Age: Mid-forties to mid-fifties.

The Operation: Rhinoplasty involves reshaping the nose by reducing a hump on the bridge, changing the shape of the tip or profile, narrowing the nostrils, or altering the angle between the nose and upper lip.

Time to Heal: Between 10 and 21 days. There is always some bruising and swelling, particularly around the eyes, which can take up to three weeks to disappear. You will need to wear a firm splint over your nose for part of this time.

Risk Factors: Asymmetries, breathing problems, stuffiness, scooped-out bridge, overdone nostrils, infection, bleeding and skin changes around the nose.

How Long It Lasts: The results are permanent, although the tip of the nose will drop with age.

Costs: From £4,000 to £6,000, plus hospital and anaesthetist's fees. OPTIMUM AGE Late teens to thirties. It is unwise to operate on the nose before the age of 16, as it is still growing. The tip is sometimes reduced at the time of a face-lift, as it droops with age.

The Operation: If your breasts are too small, placing an implant under the breast tissue, around the nipple or through the armpit can provide volume and shape. Should your breasts be sagging — after multiple pregnancies, breast-feeding and weight shifts, for example — a lift (or mastopexy) involving the removal of surplus skin may be required, with or without an implant.

Time to Heal: Between 14 and 21 days.

Risk Factors: Possible complications of implants are infection, bleeding, asymmetry between breasts, poor positioning, silicone leakage and scar contracture. (This is when scar tissue round the implant tightens, making the breasts feel tighter. It can potentially distort the breast shape, but this happens in fewer than 5% of cases.) Visible scarring varies between individuals. The risks of breast lifts include possible numbness of the nipples. In all cases of mastopexy, there is visible scarring. Augmentation is a simpler operation, owing to the small scars involved.

How Long It Lasts: The lifespan of a breast implant can be up to 16 years. After a breast lift, breasts will eventually droop with age and weight changes.

Costs: Between £3,500 and £7,000, depending on the extent of the procedure.

Optimum Age: For lifts, after childbirth; for augmentation, twenties or thirties.

The Operation: The tummy tuck (also known as abdominal reduction or abdominoplasty) is surgery that flattens the stomach by removing excess fat and skin, and tightening the muscles of the abdominal wall. Typically, incisions are made around the bellybutton and across the pelvic area in a U or V shape. In cases where there is only a little skin to be removed, the scar may be shortened and placed just above the pubic area.

Time to Heal: About six weeks before you can resume normal activities.

Risk Factors: A tummy tuck is considered major surgery, and involves a general anaesthetic and a short stay in hospital. Risks include blood clots, infection, raised scars and prolonged numbness. All patients are left with noticeable scars.

How Long It Lasts: The results are permanent, but the skin will become looser over time. It is often combined with liposuction to reduce hip and thigh bulges.

Costs; In London, f5,000-£7,000£, plus the cost of 1-2 days in hospital and general anaesthesia; much less in South Africa.

Optimum Age: Post-childbirth.

The Operation: Picture this: you come in with a paunch around your middle; you wake up and it's gone. Liposuction (also known as liposculpture, or suction-assisted lipectomy) is a tried and tested surgical method of reducing fatty bulges from thighs, hips, waist, buttocks, arms, chin, knees, ankles and anywhere else you can think of. Through tiny incisions, the fat is suctioned out through an instrument that looks like a knitting needle, by way of a long tube.

Time to Heal: Up to two weeks before you can go about your everyday business. Expect considerable bruising and pain.

Risk Factors: Liposuction is quite safe if performed by a qualified surgeon; risks include infection, excessive swelling, rippling, dimpling and dents, as well as asymmetries and other contour irregularities.

How Long It Lasts: The fat cells removed are gone for ever, but you will still have fat cells that can expand if you gain weight after surgery. It is best to wait until you are comfortable with your weight before having surgery.

Costs: Between £4,000 and £6,000, depending on the number of areas you want to have treated, excluding hospital and anaesthetist's fees.

Optimum Age: Have liposuction while your skin is still springy and can snap back into position easily.

The Operation: Surgery to correct drooping upper lids and/or puffy fat bags below the eyes (known as blepharoplasty) works by removing excess fat and skin, and tightening loosened muscle. Typically, incisions are made in the crease of the upper eyelid and below the lash line. In some cases, fat bags may be removed from an incision inside the lower lid, so there is no visible scar. Laser resurfacing and peels may also be done to reduce fine lines and discoloration of the lower eye area.

Time to Heal: Between 10 and 14 days.

Risk Factors: Tightness, numbness, excessive production of tears, pulling down of the lower lid, poor scars and difficulty closing the eyes if too much skin has been removed. Overdone eyelid surgery may leave you looking a little cat-eyed, or may change your usual expression.

How Long It Lasts: The results are permanent, but the surgery may need to be repeated after about 10 years. If only fatty deposits are removed, excess skin may need to be removed later on.

Costs: From £3,500 to £5,000, plus hospital and anaesthetist's fees.

Optimum Age: Over 35, depending on genetics; eye bags often run in the family.

The Procedure: Lasers are used in a variety of ways. An ablative laser will give you a peel and burn off surface layers of skin. A non-ablative laser is used to give a form of face-lift, minimising wrinkles, increasing collagen production and tightening skin. Intense pulsed light (IPL) is used for hair removal and to treat pigmentation and blood vessels. It takes only a few minutes and requires only a topical anaesthetic cream.

Time to Heal: IPL and non-ablative laser treatment usually require no downtime, although there may be some redness. Ablative laser treatments can leave darkened areas for 7-10 days.

Risk Factors: Pigmentation, especially on darker skins, scars and blotches. IPL can cause scars, so requires a trained specialist.

How Long It Lasts: Light treatments usually involve three or more sessions. Deeper lasers may zap a brown spot in one go, but skin-tightening procedures with non-ablative lasers require more.

Costs: Fees vary by device, and range from £250 to £500 per area per treatment; several treatments are usually required.

Optimum Age: Your thirties are a good time to start, although earlier would be appropriate for imperfections or skin conditions that require treatment, such as rosacea, acne or melasma.

The Procedure: These red, squiggly lines appear on the face, legs, nose, chest and arms. Those on the face can be treated with IPL; elsewhere, injections of various solutions (including salt water and detergent) and/or laser therapy can be used to zap the vein and cause it to collapse. Electrolysis can work, too. Thread veins appear mainly near the surface of the skin, whereas deeper veins, often blue or purplish, appear on the legs. The energy emitted by the laser is absorbed by the redness of the blood in the veins - although only one in three leg veins responds to lasers. Over time, the closed-off vein will be absorbed and disappear.

Time To Heal: Some swelling and redness for a couple of weeks.

Risk Factors: Infection, swelling, bruising, scarring, discoloration and recurrence of veins.

How Long It Lasts: Veins may disappear permanently, but new ones could appear.

Costs: £250 per treatment; multiple treatments are needed.

Optimum Age: As needed, thirties and up.

The Procedure: A chemical solution is applied to the cleaned skin and left on for a specified period of time. A deep peel will remove some wrinkles.

Time to Heal: Light peels require no downtime and can be done in a lunch hour. Deeper peels, including Obagi (based on trichloroacetic acid), will result in flaking or peeling and will require a week to heal.

Risk Factors: A change in skin pigment (lighter) is the biggest potential problem; others include skin-darkening, blotches, scabbing, irritation, redness and increased sensitivity. The new skin will be pink and sensitive, and will stay that way for 2-3 months.

How Long It Lasts: Superficial peels with glycolic acid require 4-8 sessions; medium and deeper peels, using trichloroacetic acid, may be a one-off event. For sensitive skin, glycolic-acid treatments may be milder and spaced further apart.

Costs: From £100 to £400, depending on the type of peel and the extent of the treatment.

Optimum Age: Teens and twenties for acne and spots; thirties and upwards for skin maintenance. The older you are, the more damage there will be to treat, and the stronger the peel programme required to gain visible results.

The Procedure: Radio-frequency waves are used to deliver energy to tighten loose skin on the neck, face and body. Energy is produced by a radio-frequency generator instead of a light source, and there is a device that delivers coolant to the skin. This deep, uniform "volumetric" heating action causes the collagen and elastin in your skin to contract immediately, thereby producing a tightening effect. This does not affect the epidermis (the top layer of skin). Over time, remodelled collagen is produced to tighten skin further, resulting in smoother skin and a more even appearance. It can be helpful for acne scars, as well as moderate wrinkles and any skin sagging of the face and body. Oily skin can also benefit dramatically.

Time to Heal: There is no real downtime, and make-up may be worn at once.

Risk Factors: This treatment can be quite uncomfortable. Risks include scarring, contractions, dimpling, skin irregularities and asymmetries, as well as a lack of visible improvement.

How Long It Lasts: For 30% of patients, a mild immediate tightening is seen, with further recontouring and remodelling over 2-6 months. Results are variable and somewhat underwhelming; more than one treatment may be required.

Costs: From £2,000 per area per treatment.

Optimum Age: From 35 to treat mild skin laxity. It can also be preventive.

The Procedure: Fat is taken from your bottom, hips or thighs, processed in a centrifuge and reinserted (not injected — the doctor uses a special instrument) into creases, lips and dents that need plumping. The effects are variable; overcorrection is usually needed, causing additional swelling, and more than one treatment is recommended for long-lasting results.

Time to Heal: Expect swelling or bruising for several days.

Risk Factors: As it is your own fat, you cannot be allergic to it. Lumps and bumps are possible, especially in thinner-skinned areas, such as around the eyelids. Be prepared for a lot of swelling if you have it in your lips.

How Long It Lasts: Between six months and several years, depending on how much fat is removed and how deep it is injected. Fat cells will stay alive permanently if there are blood vessels to feed them.

Costs: From £800 to £1,500 per session, depending on how many areas are treated.

Optimum Age: Forties and fifties for volume replacement and deep creases.

The Procedure: Restylane is injected primarily into and around the lips to create volume or fill out wrinkles. There are many hyaluronic-acid gel wrinkle-fillers on the market, including Restylane, Hydrafill, Viscontour, Purogen and others. The Restylane family (www.restylane.com) includes Restylane Touch, for fine lines; Restylane, for lines and wrinkles; Restylane Perlane, for creases and folds; and Restylane SubQ, for chin and cheek contours. Each product is injected into a different layer of the skin, and different consistencies are used for different depths of wrinkles. The thicker the filler, the deeper you inject it.

Time to Heal: There may be some swelling or bruising for a day or so. Make-up can be worn straightaway.

Risk Factors: Hyaluronic-acid gel is broken down by the body over time, and is considered very safe. The dreaded trout pouts are usually caused by longer-lasting, more permanent fillers, rather than hyaluronic-acid gels.

How Long It Lasts: Upwards of three months or longer, depending on which product is injected and how much is used.

Costs: £300 per 1ml syringe; a typical treatment uses two syringes.

Optimum Age: Thirties for lips and contours; forties for lines and wrinkles.

The Procedure: A skin biopsy is taken from behind your ear and sent to be processed. New cells are grown in the lab and these fresh fibroblast (collagen-producing) cells are loaded into a syringe for injection into lines, creases, scars and so on. Works well for overall face and neck rejuvenation, acne scars and décolleté creases, as well as hands that need plumping up. For more details, call 020 8834 1080 or visit www.isolagenuk.com.

Time To Heal: No downtime. Make-up can be worn immediately.

Risk Factors: No allergy risk, as the process uses your own cells. However, it may not work if protocols are not followed correctly — for example, if samples are mixed up.

How Long It Lasts: Cells continue to grow for 12-18 months and longer. As your own cells are stored, you can have additional treatments to maintain results or treat new areas.

Costs: About £2,900 for two treatments; £3,500 for the full face.

Optimum Age: 35 and up.

Botox was first used in 1978, to weaken overactive muscles in the eye, then to treat other neurological conditions, such as facial and neck muscle spasms, with good results and few side effects. It was first used cosmetically in 1990, to reduce facial wrinkles that arise from muscle contraction, such as frown lines, forehead lines and crow's-feet. Although Botox is increasingly popular, many women (and men) seduced by its quick-fix appeal are scared off by a lack of research into the long-term effects of its use.

What Is It And How Does It Work? Botox and Dysport are the trade names for Botulinum toxin, which is produced by the bacterium Clostridium botulinum. Botulinum type A, which is used commercially, is the most potent. Botox acts by blocking acetylcholine, a chemical that is responsible for transmitting the electrical impulses that cause muscle contraction. This results in muscle paralysis, but only temporarily, as the new growth of nerves re-innervates the muscles.

The Procedure: Botox is injected in highly diluted doses into the belly of the muscle using a small needle. This causes it to relax, which softens lines and contours. The most popular areas to have treated are crow's-feet, forehead lines, neck muscles, the corners of the mouth and upper lip lines. Several injections are usually needed at specific sites, depending on the area treated.

Time to Heal: Make-up can be worn immediately.

The Results: Botox usually takes effect 1-3 days after the injections, with maximum effect 1-2 weeks later. The effects last for about three to four months. When injected into the muscles that are responsible for expression wrinkles, it gives the face a more relaxed and smoother appearance.

Are There Limitations? Botox is effective in reducing wrinkles that have been caused by muscle contractions, but it has no effect in reducing fine lines on the face due to sun damage and those caused by sagging facial skin.

Risks and Contraindications: Possible side effects include headaches, eyelid droop, swelling and bruising. Botox should not be used by pregnant or breast-feeding women, anyone with neuromuscular disorders or people taking certain muscle relaxants.

How to Avoid Frozen-Face Syndrome: Nobody minds losing the odd frown, but be wary of removing all expression, particularly around the eyes. In other words, pick the expressions that you want to take out, carefully and sparingly.

Is It Safe? Long-term evaluations have not been conducted, but the overall safety of Botox is well established - it is approved by health authorities in 70 countries. However, it is important to note the following: in the UK, Botox can only be prescribed by doctors. Nurses can perform the procedure under the direct supervision of a doctor, provided the patient is counselled by a doctor first.

In addition, in the UK, Botox is only licensed to treat squinting, facial and neck muscle spasms, cerebral palsy and excessive sweating. Injections for cosmetic use are considered "off label", and a doctor is obliged to tell a patient this and take responsibility for the drug administered. This underlines that Botox is a medical procedure that requires appropriate training to ensure safety as well as a favourable aesthetic result. That said, according to the British Association of Aesthetic Plastic Surgeons, it is not dangerous when used properly, and even if the use of Botox resulted in the wrong muscle being paralysed, the effects would be temporary.

Costs: From £250 per area treated.

Optimum Age: Thirties. Botox is preventive and corrective.

Overdone Nose: Scooped dorsum, pinched tip, too small for your face, too short, you can see inside the nostrils

Oversized Or Badly Positioned Facial Implants: Cheeks and chins that bulge in odd places

Eyes That Don't Close: Sclera show, lid lag, upper lids so tight they squeak, almond-shaped or cat's eyes (this comes from too much lateral pull or too many mini or upper face-lifts)

Wind Tunnel: A too-tight face-lift that has erased natural lines of expression or movement

Overpeeled: Shiny, white, detextured skin that doesn't match the neck, hands or chest Trout Pout: Overfilled lips with ridges that interfere with the ability to smile

High Brows: The "rabbit caught in headlights" look of an overlifted brow. Brows should not be stretched too high.

Hollow Eyes: Too much fat has been removed, leaving a gouged look

Many procedures are reversible, or can be improved or made to look better if you are not happy with the results. For example, an overdone nose may be altered with autologous (from the patient's own body) or alloplastic (synthetic) implants, which are used to build up depressions and scooped-out profiles, and to add projection to overshortened tips.

Facial implants can be removed and left out permanently, exchanged for a smaller implant or repositioned where the implant should have been placed originally. In some areas, such as the eyelids, where the skin is the thinnest on the body and tends to be unforgiving, poor results are more difficult to repair.

If a face-lift results in asymmetry, or pulls the skin in the wrong direction or is too tight, you are left with two options: waiting until the skin loosens up on its own or having more surgery. The downside is that you will have to start the healing process all over again.

Getting Ready For Surgery

One Month Before: Go for blood tests, ECG, chest x-ray and mammogram, as instructed. If you are having facial surgery, when you go for your last haircut, make sure that you keep it long around your ears

Three Weeks Before: If you are taking any vitamins and supplements, you will probably be advised to stop. Vitamin E, for example, thins the blood and can aggravate bleeding. Quit cigarettes and nicotine substitutes — smoking is the main cause of reduced healing

Two Weeks Before: If requested, discontinue hormone-replacement therapy. Load up on vitamin C (1g-1.5g per day). Cut down on alcohol

One Week Before: Last chance to colour or perm your hair, as fresh scars are sensitive to chemicals for a few weeks. Pick up a camouflage cream and green undertone to conceal bruises. Get any supplies that your surgeon has advised from your pharmacy: for instance, gloves, gauze, hydrogen peroxide, swabs. Arrange to have a friend or family member take you home after surgery.

The Day Before: Stock your larder with low-salt broth, juice, water, teas and soft foods. Start taking arnica tablets or capsules if your doctor allows it. You may be advised to start a course of antibiotics before you undergo surgery. Call your surgeon's office to confirm your time of arrival at the hospital. Schedule your first post-surgery visit.

The Night Before: Remove nail varnish if requested, and contact lenses. Wash your hair twice, so it's as clean as it can be while you're in. Fill all the ice trays in the freezer, discontinue hormone-replacement therapy. Load up on vitamin C (1g-1.5g per day). Cut down on alcohol.

Tags: cosmetic surgery,