They’ve fi­nally got the fig­ures they yearned for. Just one prob­lem: it’s taken an un­ex­pected toll

Scottish Daily Mail - - Femail Magazine - By Sarah Rainey

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.

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.

For 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.

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.’

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 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.

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 4st, 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.

‘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.’ 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.’

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.

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.’

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.

Feel­ing fit­ter — but look­ing older: An­n­marie Sweeney, left, and Jo Lay­bourn

When I was big­ger, I could have passed for be­ing in my twen­ties. To­day, I’ve hooded eyes and wrin­kles AN­N­MARIE LAST YEAR

JO LAST YEAR Af­ter los­ing four stone in seven months I feel fit­ter and health­ier but the flip side is I look drawn and old



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