Cutting away all sign of age

According to best-selling self-help books author Harold Bloomfield, having plastic surgery 'is all about our fear of death'. Once our facial skin and muscles begin to head south, says Bloomfield, that reminds us we have only got a limited time to do whatever it is we want to do with our life.

If that particular theory holds true, then Americans are much more scared of dying than ever. And they start worrying about it earlier, too.

The United States has, of course, long led the world in its pioneer spirit towards plastic surgery. Even the preferred term 'cosmetic surgery', while typically euphemistic, suggests something that is as socially acceptable as using moisturiser or lipstick.

Since the early 1970s, the rest of the world has looked aghast upon the images of spoiled Californian beach bunnies or Upper East Side ladies-who-lunch availing themselves of nose jobs, breast implants, or a face-lift; but while the French have preferred to grow old gracefully and the British to grow old stoically, Americans have been nipping and tucking without the slightest shred of social stigma.

But if business was booming for plastic surgeons in the 1980s, it has skyrocketed in the 1990s. No longer the lone domain of Hollywood celebrities or middle-aged women, the industry has seen a startling demographic shift towards the less well-off, the younger baby boomers, and a fair swathe of men.

The American Society of Plastic and Reconstructive Surgeons has released figures showing that nearly 700,000 such procedures were carried out in 1996 - a massive 76 per cent increase on 1992. And the boom continues unabated, with hospitals reporting hikes in business of up to 20 per cent in the past year. The world's largest plastic surgery hospital, in Manhattan, has eight operating rooms fully booked from dawn till dusk.