The body of the future

Will science deliver what nature never could - perfection?

Brain

It is already possible to scan the brain and "see" emotions - such as happiness and sadness - as lit-up areas. Even the voices that schizophrenics hear in their head can appear as areas of light. These developments, still very crude today, lead inevitably to the fear (or hope) that one day it will be possible to read the mind.

As science finally makes sense of the brain and consciousness, alarming possibilities will arise. What do we do when we find the intelligence gene? Do we want to make everybody an Einstein? Equally thorny are the already mooted criminal and homosexual genes. Or the depression gene - it may be possible to stop anybody ever feeling depressed but is that what we want?

Lurking in the body of the future may be a super-intelligent, peace- loving brain that won't deteriorate with age. According to Dr Peter White, consultant psychiatrist at St Bartholomew's Hospital, if you are 25 now, there will be a cure for Alzheimer's Disease before you are old enough to suffer from it.

Hair

For people with too little hair, the future is bright. Says Mr Mel Braham, aesthetic surgeon and chief executive of the Harley Medical Group: "The next couple of years will see the introduction of tissue expanders which expand the area of the scalp with growing hair like a balloon. The bald area can then be removed, the two expanded sides get stitched seamlessly together and the hair will continue to grow."

Drug-based research also looks hopeful. Professor Nicholas Lowe who runs both London's Cranley Clinic and the Southern California Dermatology and Psoriasis Center thinks the key to encouraging regrowth when hair falls out lies in the enzyme Alpha 5 Reductase: "We think it is responsible for turning hair growth off; we may be able to use a drug to block the enzyme - and the bald man's hair will grow again."

For those with hair, too, the future is exciting. As technology improves, it will be possible to change your hair colour and texture every day. "We will see products that can be removed without damaging the hair and therefore versatile colour, that changes every day, could be possible," says hair colouring expert, Jo Hansford. Colin Greanery, artistic director of the hair salon Mahogany, adds: "A natural-looking hair colour treatment will be available in the form of a serum which develops in a matter of minutes, using a gentle blow-drying technique. This will enable blondes to turn brunette for a day!"

Reproduction

The sperm count of men in the West appears to have halved in a generation and women are not trying to conceive until later in their reproductive lives when fertility is lower. But there is no need to panic: technology is already so well advanced that many experts believe that any fertility problems which may arise as a result of these trends can be overcome with, for example, micro-injection techniques. "Ninety-five per cent of fertility problems could now be overcome with unlimited ethical and financial resources," says Dr Simon Fishel of Nurture, the reproduction research organisation. "I believe we have conquered the problems of infertility on a scientific level. This does not mean of course that every couple can physically have a baby. There will still be the need for surrogacy in the future, and it will probably become increasingly acceptable as the ethical boundaries get stretched. Parents will know more and more about their children at embryo stage."

In the future women might abandon the burden of childbearing altogether if the development of the external womb (being researched by Professor Mark Hanson at London University, primarily for the benefit of premature babies) catches on.

Parents of the future could avoid later trauma for their children by investing in aesthetic surgery in the womb. At the moment cleft palates have been operated on successfully in utero. Currently the increased risk of miscarriage from inserting an endoscope into the womb makes purely aesthetic work unviable, but in the future a reduced risk method may be developed and you could ensure that your child will not have your nose.

genes

"In the future, it may be possible to locate and isolate the gene responsible for ageing," gushes a research chemist working for a leading cosmetics company. "The body could be injected with a drug that stops it from functioning, so we could stop the clock at 20, 50, whenever." However, most scientists are sceptical. Says Dr Teresa Marteau, a social geneticist at the Wellcome Institute: "As of June this year, there were still only 1,500 people worldwide taking part in gene therapy trials. It is very, very early days. Even in the imaginable future - in 20 to 30 years, say - we will have moved only a little in gene therapy and certainly not very far in gene manipulation. Gene manipulation - the ability to change breast shape, colour of the eyes, alter IQ and ageing - will happen eventually, probably, but it is impossible to predict when. We do know that it will take a lot longer than scientists first thought."

Face

Cosmetic surgery in general is increasing by 10 per cent a year, and the industry is making promises for the future which sound like flights of fantasy today. A woman of 60 in the year 2030, surgeons claim, will look like a woman of 35 does now; there will be no such thing as the double chin, because our descendants will have liposuction in the way that we might have a facial before a big night out; and a big nose will stand out like, well, a sore thumb, because nose jobs will have become so untraumatic.

Ears

The noise pollution of the 21st century will mean that hearing problems will affect far more people far younger. "We are getting used to far higher levels of noise," says Vivienne Michael, director of the Hearing Research Trust. "It's an insidious problem; you don't notice when you can no longer hear the birds singing, only when your family are getting annoyed because the television is too loud." Fortunately, medicine is keeping up. Cochlear implants, which electronically stimulate the hearing nerve, by-passing the damaged inner ear, are already giving the profoundly deaf some hearing. And the revolution is not going to stop: "In the future, most deafness will be curable," says Vivienne Michael.

Teeth

Modern diets require little tearing and grinding so, over the last 200 years or so, our jaws have been getting smaller and weaker and we are gradually growing fewer teeth. Twenty-five per cent of us don't develop wisdom teeth. Fewer teeth will mean more prominent cheek-bones, which could mean they become less sought after.

t "Everyone is searching for the vaccine or pill that we will be able to take to release us from the chore of brushing teeth," says Dr Bruce Hunter, director of dental services at University Dental Hospital, Cardiff. Already available in the United States, although not yet passed by EU law, is a treatment which makes teeth whiter. And a vaccine for receding gums is being developed, so no more getting long in the tooth.

In 15 or 20 years, fillings will be stuck into teeth. Currently crown work is highly destructive as so much of be tooth has to be drilled away. In 20 years dentists will be able to get the same effect with very little cutting.

Eyes

Will glasses and contact lenses become museum pieces, quaint relics of the 20th century? Although the technology may be there, it's unlikely. Keratectomies are already being performed on short-sighted patients - where a laser beam is used to alter the curvature of the eye, thereby correcting vision. A parallel treatment for long-sighted patients is being patented for use in the future. However, Mr Rod Daniel, consultant ophthalmologist at Moorfields Eye Hospital says: "Wearing a lens to correct an eye problem will still be seen by most people as preferable to having an operation, which always carries some degree of risk."

Changing one's eye colour is not on the horizon because the shade of our eyes is so much a part of our genetic make-up.

Breasts

Breasts in the West are increasing in size thanks to better nutrition. The lingerie manufacturers are already responding: Warners has just introduced the 40G bra and is now proposing the "H Bomb", while Fantasie's bras now go up to an HH cup.

Fears over breast implants will abate, claim aesthetic surgeons (but then they would). Mr Mel Braham, aesthetic surgeon and chief executive of the Harley Medical Group, claims that "nothing has ever been proven that says that silicone implants are seriously hazardous to your health, and they are passed as safe by EC directives. However, in the pipeline are implants made from more natural products like vegetable oils."

Currently British women's biggest cancer, breast cancer survival rates will continue to improve slowly. According to the Imperial Cancer Research Fund, in the first decades of the 21st century there will be DNA testing to identify those at risk and digital mammography will improve breast screening. Multi-media imaging (using isotope scans and computer-constructed images) will make it easier to predict the spread of cancer in the breast using virtual reality technology, which will come in the form of testing kits available from GPs. Women will have "designer" treatment targeted at their needs. Therapeutic molecules will be used to mimic the activity of faulty tumour suppressive genes. After 2020 there should be vaccines against changes unique to tumour cells and against cancer-causing bacteria.

Body weight

The future is fat. It is estimated that by 2005, 25 per cent of Britons will be obese (defined as having at least 20 per cent excess body weight). Defence in the weight war is being developed in drug form. Michael Lean, professor of human nutrition at Glasgow University, says: "Half a dozen weight-control drugs are in the development stage which is very exciting." They will work either by interfering with the nerve control of appetite; by increasing the metabolic rate; or by reducing the absorption of calories by the body. In tests for one product, Sibutramine, on 4,000 people, nine in 10 lost an average of more than a stone; and kept the weight off for at least a year. Sibutramine is expected to become available on prescription from next year.

The gene for obesity has been found in mice in the US. The gene makes a protein called leptin. In experiments, fat mice have been slimmed down when injected with leptin. Human trials are under way.

Genetically engineered food is another hope for the future. Scientists have developed potatoes that absorb less fat during cooking. But many experts are sceptical about the arrival of Olestra, the fat substitute, because of its unpredictable effect on the digestive system - our bodies have not evolved an enzyme system to deal with the laboratory created molecular structure of the product. Other "miracle" foods such as Fat Magnets and Fat Binders are being treated with equal caution.

Skin

Already lasers can obliterate skin blemishes, topically applied drugs can smooth facial lines, and injected agents can remove deep wrinkles. Future products will be faster, better and longer lasting. "New substances will be developed by entrepreneurs," says Mr Brian Mayou, an aesthetic plastic surgeon, "that will be more successful than the liquid silicone that we use today to eradicate wrinkles." The next major breakthrough, says Mr Mel Braham, plastic surgeon and chief executive of the cutting- edge cosmetic surgery practice, the Harley Medical Group, will be laser treatment that needs no recovery period. Nicholas Lowe, clinical professor of dermatology at the the University of Los Angeles, adds: "There will be more efficient anti-oxidants to help reduce sun damage and ageing. There will also be substances that increase the production of new collagen and elastic tissue to maintain the elasticity of youthful skin."

Lee Shreider, a research cosmetic chemist, says that we may be able to look better without any kind of operation as semi-permanent make- up gets better. "Crooked noses will be improved by effectively sealing on shaded colours that either enhance or subdue areas of the face. We will be able to straighten eyebrows and lips making the face more symmetrical - which remains one of the keys to beauty - and even close block pores with permanent, custom-designed foundation."

The development of the safe sun tan is a potential gold mine. Being researched at the University of Arizona, but a long way from reality, is the injectable tan. Professor Lowe is optimistic: "There will almost certainly be a safe way of developing a sunless tan that protects against sun damage. In animal research we've applied creams to guinea pigs that can actually 'turn on' some of the genes that produce pigmentation without any sunlight exposure."

Genitalia

Aesthetic plastic surgeons say that a 20 per cent penis extension is possible for almost every male and, as time goes on, more and more men will opt for one. "We make use of a superfluous couple of inches of the penis that is held inside the body. This was essential to sexual functioning in early man who, on all fours, needed a more precise angle for penetration," says Brent Tanner, an aesthetic surgeon who specialises in penis extension, "it is no longer necessary. Also, in the future we will have developed better materials for thickening the penis - the latest is Articoll, microgranules of bone cement."

In the 21st century the female orgasm will virtually be a constitutional right. According to Brent Tanner, aesthetic plastic surgeon: "In the future, a woman who goes to the doctor complaining of poor orgasms may have a hood on her clitoris removed or her labia trimmed to sort out the problem. The taboo over these areas now is like the one we used to have over nose jobs; people were thought to need psychological counselling if they were not satisfied with the way they looked."

Body hair

Lasers are already being used to remove unwanted hair permanently. Dr Neil Walker, laser surgeon at the Lister Hospital in London, says: "The current lasers offer effective treatment for a third of patients and this will get better and better. What holds it back is the prohibitive cost. In the United States people are paying thousands of dollars for one course of treatment. But the day will come when women will be able to have all their leg hair removed forever in just one session."

Feet

The foot of the future will be bigger, because people will be bigger generally and partly because today's young women have grown up wearing sensible shoes. The badly fitting shoes their mothers wore as children did much to stunt foot growth. Dolcis recently added size 9 to its standard range of women's shoes and Clark's goes up to 11. "In 40 years time," says Fred Beaumont, chiropodist and spokesperson for the Institute of Chiropody, "the average foot size for females will be an eight while it is roughly a five today."