There’s a saying in Hollywood, first coined by the glamorous Sixties actress Catherine Deneuve, which will strike a chord with women the world over: ‘At a certain age, you have to choose between your face and your ass.’
We all know it’s true. Once you get past the age where your metabolism keeps lumps and bumps at bay and your skin is too fresh-faced for wrinkles, you can’t possibly keep both your face and body in a state of youthful perfection.
The middle-aged women who choose to prioritise their faces are easy to pick out in a crowd. Their bodies may bulge in all the wrong places, but they have the enviable visage of a 30-year-old, with line-free foreheads, plump cheeks and dewy skin. All of which draws attention away from their steadily sagging bodies.
Annmarie Sweeney, 44, a healthcare assistant from Cheshire, says that since losing a lot of weight over the past ten months, she now looks in the mirror and doesn’t recognise the woman she sees
Nigella Lawson said she had no intention of losing weight in 2011 because it would age her - however, after her marriage breakdown she looked noticeably gaunt
Nigella Lawson, 56, is one such woman. The curvy food writer and chef announced in 2011 that she had no intention of losing weight, despite fluctuating between a size 12 and 16, because she feared it would add years to her face.
‘If I lost 40lb [roughly three stone],’ she said, ‘I would age ten years straight away.’
And the women who have done just that - focusing on their body instead of their face - know all too well what she means.
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ShareFor in a bid to regain the lithe, toned figures of their youth, increasing numbers of middle-aged women are developing a condition known as ‘diet face’.
It occurs when women over 40 lose weight or embark on a strict healthy eating plan.
As the pounds drop off, the years start showing up on their faces. Wrinkles and crow’s feet that were once plumped by fat appear out of nowhere; their previously apple-like cheeks look hollow and skin turns sallow.
Jo Laybourn, 44, from Chelmsford, Essex, who works for a children's charity, says that since she has lost 4st, she’s become conscious of the lines around her mouth
Rather than recapturing their youth, these women - having finally achieved the figure of a much younger woman - end up looking several years older than they actually are.
Scientists have recognised the phenomenon for some time. In 2009, a team of researchers in the U.S. found that losing as little as 10lb - or the equivalent of one dress size - can age an older woman by four years.
In women over 38, the study authors said, a full face looks younger than a thin, gaunt one.
‘Losing fat from the face gives the appearance of being unwell,’ says Harley Street facial surgeon Dr Ayham Al-Ayoubi.
‘With weight loss, many people develop a hollow area under the eyes and their skin becomes dehydrated and wrinkly, making them look old. A plump, arched face is a sign of youth; one that is concave and bony looks far older.’
Annmarie says that when she was bigger (left) she could have passed for being in her twenties. She says that after losing weight she now has hooded eyes and wrinkles
Jo says she now feels fitter and healthier but thinks the downside is that she looks drawn and old
Even celebrities aren’t immune from developing ‘diet face’ after losing weight. The gaunt, hollow-cheeked look has become commonplace among middle-aged A-list actresses and models - so much so that surgeons are fielding soaring numbers of requests for procedures that reverse its effects.
A recent survey of surgeons worldwide revealed a 50 per cent rise in cheek plumping and fillers among 40 to 59-year-olds in a bid to restore their youthful complexions.
Among some of the most high-profile sufferers are stars whose extreme diet regimes have taken a heavy toll on their looks.
In the 20 years since she came to fame, Victoria Beckham, 42, has gone from chubby-cheeked Spice Girl to having jutting cheekbones, circles under her eyes and a permanently pinched expression.
When, in 2014, she appeared at an awards ceremony in London after a period out of the spotlight, fans remarked that her face looked ‘old’, ‘miserable’ and ‘too skinny’.
Madonna, pictured left in 2015 and right in 2008, has seen her looks change vastly due to different dieting and exercise regimes
Victoria Beckham, 42, has gone from chubby-cheeked Spice Girl to having jutting cheekbones
Madonna and Friends actress Courteney Cox have the affliction, too, attributing their drawn, lined faces to an obsession with keeping their figures in shape.
‘In Hollywood, to get your bottom half to be the right size, your face may have to be a little gaunt,’ admitted 51-year-old Cox, who works out four times a week to maintain her bikini body.
Madonna, 57, a notorious fitness obsessive, conceded: ‘Several years ago I knew I had to choose between my face and my body. I always knew I’d choose the latter.’
But Fern Britton, 58, is possibly the most striking example of a diet face in the public eye.
Before the TV presenter had her £8,000 gastric band fitted in 2006, she was known as the bubbly face of This Morning, whose youthful smile and sunny demeanour were more remarkable than her size 16 figure.
Afterwards, when she dropped five stone to become a slimline size 12, viewers said that she appeared to have aged dramatically, with bags under her eyes, lines around her mouth and sagging jowls that had never been there before.
Actress Courteney Cox, 51, has attributed her drawn, lined face to an obsession with keeping in shape
Fern Britton, 58, is possibly the most striking example of a diet face in the public eye. After dropping five stone to become a slimline size 12, viewers said that she appeared to have aged dramatically
Jo Laybourn, 44, who lives in Chelmsford, Essex, with Mark, her husband, and works for a children’s charity, says that since she has lost 4 st, she’s become almost wary of smiling because she’s so conscious of the lines around her mouth.
She says her weight has always fluctuated, but during her two pregnancies she gained a lot.
‘After giving birth to Ben, who’s now eight, and then Joshua, who’s five, my weight went up to around 13st 7lb and I was a dress size 16.
‘Towards the end of 2014, I saw a hideous photograph of myself looking huge - and that spurred me on to start losing weight.
‘I lost more than 4 st in seven months, by eating healthily and exercising, and now I’m a size 8.
Jo was spurred on to start losing weight after she saw a 'hideous' photograph of herself at the end of 2014
Jo says she does not regret losing weight, but if she could afford to splash out she would get some fillers to get her youthful plumpness back
‘I feel fitter and healthier - but the downside is the effect this weight loss has had on my face. I look drawn and old. I have deep wrinkles around my eyes and lines down either side of my mouth.
‘I didn’t see it coming. I thought getting fit would make me look and feel younger, but instead it’s given me an aged face.
‘I don’t regret losing the weight, but if I had all the money in the world I’d have some fillers to get my youthful plumpness back.’
So what exactly causes ‘diet face’ - and can anything be done to reverse it?
The key lies in the make up of the human face, which is comprised of several different fat compartments, located both immediately under the skin and within our bone structure.
When we’re young, these compartments are readily supplied with nutrients, keeping them plump and youthful. As we age, however, these nutrients are diverted elsewhere in the body, causing the fat pockets to start deflating.
‘This leads to gravitational descent,’ explains Dr Costas Papageorgiou, a surgeon who specialises in facial rejuvenation.
‘Volume loss in one area can affect neighbouring tissues, leading to a cascade of ageing signs: eyebrow deflation, jowling and neck laxity.’
Annmarie says her face now looks drastically different - when she was bigger it was round and plump
She said she started losing weight after a traumatic few years in which she lost her mother to pneumonia and then suffered a heart attack herself
This natural deflation begins in our late 30s and is accelerated by weight loss, which breaks down the scaffolding under the surface of our skin and causes the face to sag.
‘Older, thinner skin is more vulnerable to volume changes of the fat compartments,’ says Dr Papageorgiou.
‘Weight loss unveils the bony anatomy of the face, especially in the forehead and eyes, which in turn accelerates the ageing process.’
Annmarie Sweeney, 44, a healthcare assistant from Cheshire, says that since losing a lot of weight over the past ten months, she now looks in the mirror and doesn’t recognise the woman she sees.
‘I started losing weight after a traumatic few years in which I lost my mother, Maureen, 66, to pneumonia and then suffered a heart attack myself,’ she says.
‘It was the wake-up call I needed to get myself in shape.
‘With the help of a personal trainer and a rigorous no-sugar diet, I’m now not far off my target weight of 10 st and I’m a size 10 for the first time in years.
‘My work colleagues say they don’t recognise me - and I know that’s in part a compliment to my new figure, but it’s also because my face looks so drastically different.
‘When I was bigger, it was round and plump, and I could have passed for being in my twenties.
‘Today, however, I have hooded eyes, wrinkles on my brow and excess skin that hangs down from my chin and makes me look older.
‘People tell me they don’t notice it, but I’m very self-conscious about my face and neck.’
Suzanne Cohen, 42, says her husband, who’s a 42-year-old lawyer, told her to stop dieting because it was ageing her face so. The mother of three boys, aged seven, 14 and 15, from Finchley, North-West London, says she has always been a yo-yo dieter and lost weight running everyday
'I’d pound the pavements every day, racking up mile after mile. The first place I noticed the weight dropping off was from was my face - and instead of looking younger, I started to look gaunt and old,' Suzanne says
Slimming also causes stress to the ligaments in our face. Dr Jonquille Chantrey, a Cheshire-based cosmetic surgeon, says this can make the skin look like it’s melting. ‘The ligaments in the face support the soft tissue. If weight is lost, these can stretch and relax, contributing to the face appearing to sag,’ she explains.
‘Although these women feel more body confident, they can look more tired because the shadows on their face have shifted.’
What’s more, the very act of losing weight by restricting what goes into our body can have a direct and unexpected effect on our face.
When we lose weight, it tends to disappear from the face first, followed by the breast, buttocks and finally the hips and abdomen.
This is because fat in the face is superfluous and our bodies aren’t biologically primed to retain it, whereas the body hangs on to fat in the hips and buttocks for childbearing purposes. As a result, restricting calories can cause the face to become malnourished, explains Dr Aamer Khan, of the Harley Street Skin Clinic.
‘As a survival method, the body starts to divert nutrition to the essential organs, so the non-essential parts of the body - the skin and soft tissues of the face, neck, decolletage and hands - suffer,’ he says.
She said that when she was 'fat' she had a 'round face and podgy, young-looking cheeks'. Now that Suzanne is thinner, she said her cheeks have lost their plumpness and the wrinkles have set in
This affects women in very different ways, depending on their genetics and ethnicity.
Asian women, for example, are born with more fat in the deeper layers of their skin and so age naturally at a slower rate, even when dieting.
Caucasians have thinner skin, so when they diet in middle age, says Dr Papageorgiou, ‘their face will behave like a deflated balloon’.
Suzanne Cohen, 42, says her husband, who’s a 42-year-old lawyer, told her to stop dieting because it was ageing her face so.
The mother of three boys, aged seven, 14 and 15, from Finchley, North-West London, Suzanne says she’s always been a yo-yo dieter.
‘At my biggest, after the birth of each of my children, I weighed 11st 7lb. Today, I’m two stone lighter and wear a dress size 10.
‘I lost the weight by running. I’d pound the pavements every day, racking up mile after mile. The first place I noticed the weight dropping off was from was my face - and instead of looking younger, I started to look gaunt and old.
‘I wouldn’t say my face dropped, but it definitely started to sag downwards as the pounds peeled away.
‘When I was fat, I had a round face and podgy, young-looking cheeks. Now that I’m thinner, they’ve lost their plumpness and the wrinkles have set in.
‘I’m lucky to have my mother’s genes, so I don’t have too many fine lines yet. But losing all this weight has made me look more like her than ever before.
‘I cover the lines with make-up, but when I’m bare-faced, people could think I’m far older than I am.’
Experts say that until the age of 35 or 40, our skin is pumped full of collagen but this drops dramatically around the time of the menopause. Losing weight left Ulrika’s Jonsson’s face more wrinkly
So why is it that dieting doesn’t have the same ageing effect on younger women?
Until the age of 35 or 40, our skin is pumped full of collagen - the natural protein that gives it strength and elasticity. This declines at a rate of 1 per cent to 1.7 per cent a year from that point onwards, and drops dramatically around the time of the menopause, due to the decline in the amount of oestrogen our bodies are producing.
Without collagen, the skin loses its ability to ‘bounce back’ into shape, so as the fat in the face melts away, it’s left slack and droopy rather than stretched tight.
We’re also more prone to losing fat in the face as we get older, and less able to replace it. This is because younger women have a thicker dermis - the inner layer of skin containing the blood vessels and hair follicles - which acts as an extra shield for our looks.
‘This makes the face more resilient to the underlying volume changes of the fat pockets,’ says Dr Papageorgiou. ‘For example, the skin of a young patient undergoing neck liposuction will be thick and elastic and able to adapt to the new contour, while older patients can have significant sagging once the fat has been removed.’
Even if they do regain weight, this is unlikely to go back into the face. Because we don’t need fat in this part of the body, it will naturally settle elsewhere. As well as being the first place we lose fat, the face is the last place it tends to go back on.
An ageing face seems a high price to pay for a supple young body, especially considering all the work that goes into dieting in middle-age.
But even higher are the costs required to rectify ‘diet face’.
Experts recommend facial fillers, made from hyaluronic acid - a compound found naturally in the body - that can plump out the deflated fat pockets in the face. These cost around £150 a go, with most people needing a course of five.
What’s more, the effects last only up to 18 months and so the treatment has to be repeated or diet face will return.
‘Fillers can be used in very small doses, injected directly into the affected fat pads to recreate the lifted, smooth look,’ explains Dr Chantrey, who has performed the procedure on thousands of patients in the past eight years.
‘Temples, upper cheeks and under the lower eyelid tend to be the first key areas.’
For damage to the eyelids, chin and neck, the best option is a face lift, which pulls excess flesh upwards and inwards via an incision at the hairline. This is pricier still, costing upwards of £7,000.
With all this to contend with, it’s worth bearing Catherine Deneuve’s old adage in mind. And perhaps, when you reach that certain age, you might choose to put your body second and your face first.
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