Diary of a facelift

Plastic surgery is booming, and the nip and tuck is now a routine part of TV makeover shows. But can it really be that easy? Lesley Walden-Mills charts the pain and pleasure of her experiences under the knife

I used to think I was as likely to have plastic surgery as to invest in cryogenics. But when I turned 54, the face that confronted me in the mirror looked "lived-in"; a lifetime of sporadic skincare and many years of smoking hadn't improved it. Everywhere, people were talking about or undergoing cosmetic surgery. Women's magazines and television programmes were obsessed by it. Afriend had her eyelids operated on and looked great. Cosmetic surgery seemed no longer to be associated solely with celebrities; it was a lifestyle choice made by people like me.

I used to think I was as likely to have plastic surgery as to invest in cryogenics. But when I turned 54, the face that confronted me in the mirror looked "lived-in"; a lifetime of sporadic skincare and many years of smoking hadn't improved it. Everywhere, people were talking about or undergoing cosmetic surgery. Women's magazines and television programmes were obsessed by it. Afriend had her eyelids operated on and looked great. Cosmetic surgery seemed no longer to be associated solely with celebrities; it was a lifestyle choice made by people like me.

My husband is eight years younger than me and our daughter had just started school. Suddenly a bit of surgical intervention seemed a perfectly reasonable option. A few years before, I would have thought having surgery was caving in to the pressures of a society obsessed by appearances, but now I felt it was an independent decision: part of a life-long resolve not to accept unpalatable things that could be changed. I started cautiously to raise the subject with friends and family. In retrospect, I realise that I discussed it only with those who were likely to approve. My husband was, as always, supportive. Various people raised safety concerns and occasionally a horror story in the media would put me off the idea for a while, but over about six months I became more determined.

The cost of a facelift and eyelid surgery in England is at least £8,000, well beyond my budget. Friends told me that the standard of plastic surgery in South Africa is high - and the price would be under £3,000. Many e-mails later, a surgeon had been found in Cape Town, consultation and operation scheduled, tickets and accommodation booked. Family misgivings about my going alone were quelled when Chris, my grown-up son from my first marriage, agreed to come with me.

ON THE WAY

Arriving in Cape Town after a boring 12-hour flight, I am dazzled by the heat and light. We have chosen a self-catering apartment in a suburb near the hospital. It's dingy and small, with no air conditioning. I begin to wonder about the suitability of arrangements made in London, when budget was my primary consideration.

I meet the surgeon. I have e-mailed photos and discussed procedures and costs with him before leaving London. He stresses that I am under no obligation to go ahead with the operation. He listens to me attentively, studies my face and explains what he intends to do. I decide that the excess skin on my upper eyelid should be eliminated. "It's an easy operation, leaving only a small scar," he says. The lower eyelid is more difficult: the surgeon must be careful not to take too much skin or the eye will remain pulled down. "Very little skin will be removed, just fat."

To improve frown lines and crows' feet, he suggests Botox. I object that the results are temporary, but he says that if it is administered three times at three-monthly intervals the muscles will atrophy. At less than £95, Botox in South Africa seems a bargain.

He is at pains to point out that I must not expect miracles. If he tried to eliminate all wrinkles and sagging, my face would look stretched and unnaturally immobile. The aim is minimum intervention to achieve natural-looking results.

Would I like a local or general anaesthetic? The idea of being awake while someone cuts my eyelids is too horrible to contemplate so I opt for a general. "You English are so squeamish," he teases. "All my English patients ask for a general."

THE NIGHT BEFORE

Chris and I treat ourselves to a slap-up meal on the grounds that we don't know when I will next be able to go out in public. We are resolutely cheerful, but the occasional worry surfaces. Will I lose my sight? Will my face be stuck in a perpetual grimace? Why am I doing this to myself? Will my feminist friends(whom I haven't told) ostracise me? Will acquaintances gossip?

THE OPERATION

Chris drives me to the hospital, neither of us voicing the worries to which we later admit. Admission is brisk, and I am hustled into a ward. The anaesthetist explains the procedure, which includes a sedative with amnesiac properties. It is certainly effective, because I can't remember entering theatre.

The operation lasts three and a half hours, and my memories of the following period are confused. I sleep propped up on pillows to minimise bruising. There is a bandage around my head and a drip in my hand. My eyes are stiff and my neck and lower face feel uncomfortably tight. I am not brave enough to look in the mirror.

DAY ONE

The next morning the doctor tells me my face looks good, with little bruising, although my eyes are swollen and discoloured. I discover that I am deaf, which he says could be caused by swelling or blood, but in either case will pass soon. There are bloodstains on the pillow - I explore gingerly and discover a stitched welt running behind each of my ears and round into my hair. My eyes are sore and my sight blurred. A nurse removes the bandage and exclaims at the thin, neat wound and the lack of bruising. As I tilt my head back so that she can wash the blood out of my hair, I am painfully conscious of tension on my neck and chin.

I am allowed to leave hospital at midday, but advised not to read or watch television until the evening. When Chris arrives at the hospital, I am worried that he will find my face too terrible to look at, but he says I look better than he'd expected. Back in the apartment, I look in a mirror. My face is swollen, particularly around the eyes, but I don't look disfigured for life.

I doze through the day, trying to stay upright, and periodically applying frozen peas to my lower face and neck and cool, damp cotton pads to my eyes. I try not to worry about the deafness. Chris puts ointment on the wound and reports that it looks better already. Sleeping upright is uncomfortable. I wake in a panic to find myself lying flat, feeling I've ruined everything.

DAY TWO

Despite the puffiness and bruising, I can see that the bags have gone and my neck and lower face seem far smoother. The late afternoon brings a noticeable decrease in the swelling. My lower face and neck are uncomfortably tight and the wound is tender. Although I can read, my vision is teary and blinking is difficult. Sleep comes more easily as I decide to lie flat.

DAY THREE

The relief of being allowed to wash the ointment out of my hair! We go for a drive. I feel everyone is looking at me. My swollen, bruised eyes covered in sticky strips and blood clots look awful. My neck feels tight and has turned bright yellow.

DAY FOUR

Boredom chases us out of the apartment to a shopping mall. I hope my sunglasses, hat and scarf make me look like an eccentric English explorer, but I probably just look as though I am trying to hide something. I feel so well that we decide to eat out. My deafness has started to clear. I sleep without painkillers.

DAY FIVE

Back to the doctor to check on progress and have the stitches around my eyes out. I feel a few sharp pains, but it's over very quickly. I can wash my face and wear moisturiser and make-up, but no mascara for another couple of weeks. Everything is healing well. He tells me that even though it is a major operation, for some reason a facelift rarely causes severe pain.

DAY NINE

The deafness has gone completely and I feel sufficiently restored and presentable to visit friends of friends. The bruises under my eyes are still noticeable, but the swelling is going down.

DAY ELEVEN

The yellow bruising on my neck and upper chest has been gradually fading and vanishes today. My jaw feels tense, and there are numb patches on each side of my face, but my neck and jawline look taut and my whole face has changed shape for the better. For the first time since the operation, I wear earrings. Previously, my earlobes have felt too cut up to attempt it, but fortunately the holes are still open.

DAY TWELVE

The final appointment with the surgeon. He removes the external stitching from round my ears and hairline - the internal stitches will dissolve. "How long will a facelift last?" I ask. He says it varies enormously, but it could be up to 15 years. Of course, the skin continues to age and although moisturisers help keep it supple, they can't affect the underlying structure. Will anything delay the signs of ageing? "Don't smoke and stay out of the sun."

He takes some photographs and tells me not to smile. "I can't help it," I say. "I'm so happy."

GOING HOME

I fly back to London 17 days after the operation, feeling almost completely recovered. The procedure was uncomfortable, but the pain was minimal. It took five weeks for the bruising to disappear, but it could be concealed by make-up within four weeks. The numb patches on the sides of my face remain, but the feeling is slowly returning. I'm less impressed by Botox: the horizontal lines on my forehead are less obvious, but the vertical lines and crows' feet are still very apparent.

From the moment I boarded the plane, I had no regrets. Six weeks later, I think I look at least 10 years younger. People have commented on how well I look, rather than congratulating me on my facelift. No one has made negative remarks.

The ultimate accolade came from my daughter. We were looking at photos taken just before I left for South Africa. "You look like a granny!" she announced. "Do I?" I asked, most upset. "Not really," she said. "Just in the photo."