SMOKING, drinking, sun damage – while an entire generation of people claim they don’t feel as old as they are, their skin often gives the game away. And that’s before you factor in the wrinkles and sagging that shout ‘middleaged’.

Women who hit 50 are also faced with plummeting oestrogen levels. That’s when collagen and elastin begin to noticeably degenerate.

But there is no need to resort immediately to the scalpel. Botox and facial fillers can help keep worsening skin tone and texture at bay. Then there are laser treatments such as Thermage, which tightens and plumps skin. It’s been around for a few years and, say doctors, has been gradually refined to give fantastic results. ‘Ninety-five per cent of people having Thermage reach their expectations with no side effects,’ said John Curran. ‘And Yale studies have found that the results can last up to five years, depending on age, skin condition and lifestyle.

‘This is like setting the clock back, not stopping it.’

The best candidates are those with mild to moderate skin laxity and no excessive sun damage: people in the 35-60 age group who don’t want, or expect, a facelift.

Some report excellent results after one treatment, but John usually recommends a follow-up session six months later for maximum effect. ‘The effects are natural,’ he explained. ‘People may say you look rested. The changes are gradual, but full results should be seen within six months.’

But, he warned: ‘Don’t expect the dramatic results of surgery. These are subtle and natural-looking.’

Thermage uses radio-frequency technology to tighten and lift skin, smooth out wrinkles and improve facial contours. A treatment tip delivers a controlled amount of energy to the area being treated. This heats amounts of collagen in the deeper layers of the skin and its underlying tissue.

Not unnaturally, the skin resists – and that results in tightening. ‘It’s acting as if it’s burning the skin, tricking it into thinking it has been burned. But there’s no danger.

‘The skin thinks it has to heal and makes collagen,’ John explained.

The technology has been around for six or seven years in this form. ‘It’s been shown that if you heat the skin to a level of 59- 60C, it promotes tightening of collagen fibres and stimulation of new fibroblast – the precursors to forming collagen in skin. That’s what gives the tightening effect.’

There is nothing new about the technology – radio frequencies have been around for nearly a century – and previously this procedure was used in surgery for things such as cauterising blood vessels.

‘It’s one of a number of radio-frequency devices but it’s the only one we’ve that has reputable results,’ John ‘And they’re refining the technology time, so we expect it to get better better.’ Many of his patients decide on rather than plastic surgery.

‘Although we have surgeons within practice, many, many patients don’t it. There’s the stigma and the downtime. Some feel that the anatomy is slightly distorted by surgery. But this tightens skin where it is.’

The side-effects are minimal but selection is important. If the skin lax, it won’t work. And repairing damage is far too difficult, said ‘You’re pushing against the wind. might benefit, but the treatment not live up to expectations.’

I offer myself up for treatment, admit to a penchant for sunbathing a lifestyle that includes 10-hour stretches spent squinting at a computer screen and a fondness for white Still, it transpires that I am the candidate: not too much sun damage a measure of skin laxity.

‘That would be the jowls,’ I joke. Thermage is not just for faces: it’s effective on hands and bingo wings, necks, stomachs and even knees.

Reassuringly, only medically-qualified doctors can perform the treatment, which begins with a liberal application of anaesthetic gel.

An hour later my face is numb and John and the magic machine are systematically working on my face, with special attention to problem areas. It’s not the most relaxing half-hour I’ve ever spent, but is uncomfortable rather than painful.

As each ‘dose’ of radio waves is delivered there is a sharp sensation, rather like rubber bands pinging the skin. The machine makes a high-pitched noise followed by the ‘put-put’ of the cooling device that helps to minimise discomfort.

‘Feel the heat?’ says John. I do. But that’s good. ‘If you don’t, the process isn’t working.’

And the results are immediate. In the digital photographs taken before the procedure I look like an ageing convict – it’s shocking. Afterwards, there is actually a discernible jawline. My face feels numb – that’s the anaesthetic still at work – but apart from a little redness, which is easily covered, there are no side effects and I go straight back to work and into a meeting.

No one notices anything amiss. The burns, bruises and dents reported by some tabloid newspapers are rare, John told me. ‘This is virtually without side effects apart from some redness.’ The outcome of the second treatment, six months later, is even more noticeable. ‘That’s when you see the real results,’ said John.

Afterwards, there is definite general tightening, especially around the chin and neck. As a bonus, my skin feels incredibly soft, with lifting around the eye area – a welcome antidote to all those hours of peering.

‘Don’t people tell you how well you look?’ John wants to know. Well, no. Not usually.

But in the following two days, three do. And in the weeks that follow, the tightening effects not only last, but continue to improve.

Now that’s what I call a result.