1. The Botox brothers

The office of what I assume are the world’s only plastic surgeon twins, Maurizio and Roberto Viel, is in London’s Harley Street. At the London Centre for Aesthetic Surgery you can have almost anything done from liposuction to breast (and even penis) enlargements. For now, I am here for Botox and fillers. Next time, I might be coming to have my fat harvested.

“Botox is one of the most effective anti­-ageing treatments because it gets to the cause of lines and wrinkles on the upper part of the face,” says Roberto. “But in the future your own fat will be your best weapon for anti­-ageing because we can use it to volumise the face in a way that is much more effective than a man-made filler.”

“A filler is a quick fix,” adds Maurizio, “but if you want to gain more in the long run, your own fat is best. That’s why keeping a little fat in the body is always beneficial.” The brothers have started to cultivate clients’ fat for skin rejuvenation. They explain that fat is rich in stem cells, famous for their rejuvenating potential, and that it stimulates the production of new blood vessels and collagen, the substance that keeps our skin plump and young looking.

I ask the Viels what clients are looking for nowadays, and what has changed in the 20 years since they started their practice. “They want maximum results with minimum downtime,” says Maurizio. “We no longer do strong peels, which we used to get very good results from, because patients just can’t take a week to recover nowadays and the effect was a bit traumatic for them.”

“They want something that doesn’t look like they’ve had anything done,” adds Roberto.

We are ready for my treatment. Roberto asks me to frown and smile and puts little dots where he is going to inject me with Botox. “A little scratch,” he warns me as the first needle goes in. It is not pleasant, but not terribly painful either. Next up, Maurizio studies my face with his eyes and his hands, like a sculptor planning his masterpiece. He also covers my face in dots to show where the fillers will go. As he inserts them, Roberto strokes my head and tells me how well I’m doing.

The twins lead me to the mirror to admire their handiwork. The Botox will not show for several days, but the fillers already show. I have a few red bits from the needle, but on the whole my face looks a lot perkier. I look more alert, more alive – “younger” is the only way to put it. And, funnily enough, happier. One of the effects of ageing is that everything in your face droops, which inevitably makes you look miserable. Maurizio and Roberto have lifted it all in a matter of minutes. But they insist my own fat would be more effective.

“Keep some fat,” Roberto urges me as I say goodbye. “We will use it to very good effect.”

Maurizio nods in agreement. “Eat some pasta.”

 Botox and fillers start from £250 for one area

2. The hand makeover

“Women all take care of their faces,” says Dr Mohammed Amir, specialist dermatologist at the Aesthetic clinic in Abu Dhabi. “But two other things make them look their age: their necks and their hands.”

“The gaps are extremely ageing, and affect very slim women more than others. But you are fine,” continues Dr Amir. The excellent news is that if I haven’t got gaps now, the likelihood is that I won’t ever. “But there are wrinkles,” he says, his caress turning into a pinch. “And the skin is getting very thin.”

Dr Amir suggests we do a Pixel session. This is a laser procedure which basically heats up the lower dermis of the skin, to the extent that it thinks it is being damaged, thus triggering a healing process that means you end up with younger-looking skin due to the increased collagen and elastin that is produced to heal it.

Dr Amir says I will see some difference after one session but that ideally I should do three or four. He also mentions, in passing, that he thinks I need my lips done (much as I fear the dreaded “trout pout”, I have always felt my lips are a bit puny). And he points out that I have platysmal bands around my neck. Great. I don’t even know what they are, but apparently they can be nixed with Botox. He gives me a mirror and tells me to speak. He’s right, there are sinew-like things protruding on my neck. Happily, I’m wearing a scarf.

One thing I have noticed in my conversations with anti-ageing experts is how matter-of-fact they are when it comes to telling you what else is wrong with you, a sort of “no offence, but have you ever thought about a facial peel?”. I’m not sure I needed to know about my platysmal bands, frankly. Can we just get back to my hands?

Dr Amir’s crisply clad nurse applies some pain-killing cream, then puts some fetching blue rubber gloves on my hands and leads me downstairs to where Dr Amir is waiting with the laser. I sit down in a large leather chair and am asked to wear strange-looking protective eye gear so that I can’t see a thing. While I sit in darkness pondering the torture scene from Orwell’s 1984, Dr Amir removes a glove and gets to work. He moves the laser systematically across the back of my hand, and presses something that makes it go click. “Does it hurt?” he asks.

“No, not really,” I reply. I think I can smell the hairs on my hands burning, though.

The procedure lasts for about five minutes, but as soon as he has finished, my right hand starts to feel extremely hot and uncomfortable. A nurse puts what feels like an oversized ice cube on my hand and rubs it around, which feels lovely. The left hand is soon finished and I can take off my eyewear. My hands have hundreds of tiny pinpricks in them.

“These spots will turn into scabs,” says Dr Amir. “Do not remove them. I will give you some healing cream to apply every four hours for four days. And of course you need to wear sunscreen every day.”

The next morning my hands are slightly swollen and the scabs are starting to appear. Putting hot water on them is really painful. It occurs to me that I haven’t really “tricked” my skin into thinking it’s been damaged so it produces more collagen; the lower dermis has being damaged, and the evidence is there in the form of my swollen, scabby hands. My husband thinks I’m nuts and just shakes his head when I show them to him. But I have faith, even though for the first few days my hands look older than ever. “They look like they’ve been under the grill,” says my friend Carla when I get back to England. “Like kippers.” There is an awful moment when my teenage daughter goes to hold my hand and recoils in horror. It’s not until a full two weeks go by that they start to look normal. And then they begin to look better; the skin tone more uniform. As Dr Amir pointed out, the results should keep improving as the months go by and skin regenerates, so perhaps the best is still to come.

Pixel hand treatments start at £200 for one hand

READ: 50 ways to look younger

3. The drastic haircut

I have guarded my long hair like a national treasure for as long as I can remember. Nothing could persuade me to part with it. In fact, I spent most of 2008 adding to it with hugely long extensions that made me look like a Wag. Looking back on it, I must have been insane. It’s enough trouble looking after your own hair, let alone someone else’s. As part of my anti-ageing quest, I have taken it off. To the uninitiated, a haircut might not immediately seem like a radical procedure in the search for eternal youth, but plenty of women will know quite how serious a significant haircut can be.

I had had what I can only describe as a bad-hair month. I would wash my hair, blow-dry it, then tie it up, because it invariably looked awful: thin, unhealthy, straggly. One day I realised that it was making me ugly. In fact, it was making me look OLD. It just had to go.

This revelation came to me in Virginia Water. But rather than wait until I got back to anywhere near a hairdresser I trusted, I needed immediate gratification. You just can’t have that eureka moment and then leave your hair for another minute. It’s like suddenly deciding you want to chuck your boyfriend, then sleeping with him again. I stomped off to a local hairdresser called Mova and asked if they could fit me in, immediately. Yes, Sophie would be with me in a couple of minutes, the receptionist told me.

“I don’t know if I’m going through the menopause, or what’s going on,” I told Sophie. “But I just HATE my hair, it just hangs there looking hideous. Can you cut it off please?”

I realised that I was demanding what most women really want when they go to the hairdresser’s: a total transformation. And they are hard to come by. Luckily Sophie took it all in her stride and we agreed on a bob, a conditioning treatment, roots colour and a blow dry.

There was one panicky point when she twisted my long hair into a ponytail and said, “I’m just going to get rid of some of the length, it will make it easier to cut. Are you sure about this?” But then I remembered how much I loathed my hair and told her to go for it.

Spurred on by my transformation, I call on a fabulous Italian hairdresser called Gabriele Cipriani, who is extremely passionate about women, in a way that only a gay man can be. Gabriele divides the ageing process for women into three phases. Until the age of 25 you can basically get away with anything: long hair, short hair, bright red hair, whatever you want. From 25 to 55 you have to be as natural as possible, otherwise you will look older than you really are. And from 55 on you need to do something to refresh your hair, maybe cut it shorter or dye it a lighter shade. “Older skin needs a lighter colour,” says Gabriele. “And if you have a lot of grey hair a lighter colour makes maintenance easier too.”

Just as our skin ages, so does our hair, he says. We need to moisturise it more and pay more attention to it. The oil glands shrink with age and produce less oil, hence the lack of shine and moisture, and the diameter of your hair gets smaller so you have less body. If, like me, you have thin, dry hair to begin with, it’s a disaster.

There are a few things you can do to lessen the drastic effect. You need to eat well, and include some protein in your diet. Try to use a night scalp mask once a month, and a moisturising mask before shampooing once a week or so. But my top tip is to have a sharp new haircut.

A while later I am in a café in Kensington with another Sophie, a friend I have known for almost 30 years. It strikes me that the only thing that has really changed since uni is that we don’t smoke any more. OK, so we look older than we did when we first met, but we don’t feel any older. Sophie is wearing skinny jeans, a white silk shirt and leather boots. Her hair is loose, blonde and long. I am in jeans with boots too, although mine are shorter. I am having a rare good hair day, having just had my roots done and my hair blow-dried.

On a table close to us sit two other women. At first glance I guess they are about 10 years older than us. Sophie motions towards them. “Don’t look now,” she says, “but isn’t that Claire from the year below?”

“Why does she look so OLD?” I whisper.

“Well, for a start, it’s the way she dresses.”

I sneak another look. Claire is dressed in a flowery dress with a high collar; a shapeless Laura Ashley-type creation. Her hair is grey at the roots and dragged back in a ponytail. It’s almost as if she has decided that she’s a certain age and will therefore look and behave a certain age. No such risk with Sophie, who is wearing the same sort of clothes she wore when we first met and is plotting to seduce a 25-year-old on her art course. I am not quite as youthful as my friend, but I would never be seen dead at Whole Foods with greying roots or a Laura Ashley dress.

As I watch Claire and her dowdy friend walk out of the restaurant I realise that although we all age, it is up to us to take control of the ageing process. We have the power to dictate how we want to age, rather than have it foisted upon us. We can decide whether we want to look like middle-aged women or not, up to a point.

Claire is putting 10 years on her age simply by acting like she thinks a woman of her age ought to. It’s almost as if she knows no one will notice her and therefore walks around like someone who is old and invisible. She oozed that “for me the war is over” kind of attitude. This is not the way forward. We need to meet ageing head on, not just keel over and let it happen.

This is an edited extract from Smart Women Don’t Get Wrinkles by Helena Frith Powell (Gibson Square). To order your copy for £10 plus p&p call 0844 871 1514 or visit books.telegraph.co.uk © Helena Frith Powell, 2016