Have you ever seen a plastic surgeon with a face lift?

Me neither. I used to watch programmes like Ten Years Younger. (Well, which of us doesn’t wish we could pull off that trick?) On television, as in life, the customers were women, the surgeons, men. The women’s faces were sliced and stitched tighter, their teeth were filed down and sheathed in porcelain; their skin was sanded and injected by men who looked wealthy and healthy but weathered and worn. In a well groomed way, the surgeons looked their age.

And I’d think, “If cosmetic surgery is so fantastic, why don’t those men turn back their own clocks?”

I heard the answer on the radio last week. A cosmetic surgeon admitted the professionals didn’t use one another’s transformational skills. The reason being, “We know the risk/benefit ratio. Any surgeon can show his success stories but they aren’t the complete picture.”

It’s the most honest statement about cosmetic surgery I have yet come across. Imagine if it was said by a heart surgeon. Would you agree to a bypass if you knew the professionals wouldn’t risk it?

Never mind surgery, I wouldn’t buy meat from a butcher who wouldn’t eat his own produce or climb on a fairground ride if the operators were nudging one another saying, “Rather her than me.”

Yet around 100,000 of the optimistic, the insecure and the desperate went under the knife in the UK in pursuit of beauty in 2009-10. Those are the last figures we have and they were up 5% on the previous year, despite the downturn.

The figures actually say that 38,274 surgical procedures took place but they are from the British Association of Aesthetic Plastic Surgeons (BAAPS) which represents only one-third of the profession.

Nine-tenths of the surgery was on women. While the increase in breast reduction in men (27.5%) was greater than that for breast augmentation in women (10.3%), only 473 men were operated on by a BAAPS surgeons compared to 9418 women. Facelifts were up 12% in both sexes. But again, 20 times more women than men had a face lift.

Remember this is just surgery. We’d have to multiply many times more to measure the number of laser treatments, Botox injections and fillers. There are more new rejuvenating products and procedures than I can keep track of.

For me it is less a measure of pockets of continued affluence than an indication of how low self-esteem has dropped, especially in women; how the false value system of the boom years is carrying on into this time of austerity.

I’m sure we will be told that women feel they need to look as young as possible to stay in work, despite laws against age discrimination. It’s understandable in a shrinking jobs market. But I think the problem goes deeper. I think we have been brainwashed into believing that young is the only acceptable way for a woman to look. I’m convinced women have injections and implants and surgery because they don’t “think they’re worth it” just the way they are.

Now Customs and Excise is contemplating extending VAT to cover cosmetic surgery. It will add one-fifth to the price. With luck it will bring us back to our senses. That’s why I welcome it.

At the moment £200-£400 and 20 minutes of her time will rid a woman’s face of wrinkles for about six months. No anaesthetic is necessary.

Stack it up against a few trips to the supermarket and the next time she catches sight of herself in an unflattering cross light, any normally vain woman will be thinking, “why not?”

In the long run she might wonder what the injections of acidic gel that infill her wrinkles or the Botox that smooths her forehead will do to her. But for six months she’s not going to care.

I looked at the website for a clinic in Scotland. For women in their 20s, it offers skin peels and something called dermabrasion; for those in their 30s, line and wrinkle smoother, derma roller and a laser pulsed light treatment; for those in their 40s, dermal fillers, lip enhancement and skin tightening were added. And by the time a woman is over 50 they’re all on the menu.

Even after one treatment it must be hard to see lines returning. You can see why people develop a habit. Eventually many will opt for surgery.

Yet they won’t hold back time any more effectively than King Canute held back the sea.

Cosmetic surgery is a marvellous tool for people with disfigurements. It can greatly assist those deeply troubled by an unfortunate quirk of nature. But surely it is harmful to young women – some still in their teens or early twenties – who have nose jobs or breast enlargements to boost their self-esteem.

Surgery carries risks – as that surgeon pointed out on the radio.

This month BAAPS introduced a patient questionnaire drawn up by a psychologist. It is designed to identify patients who might regret surgery and who would be better having counselling. Surgeons will assess the answers before they offer a consultation. Unfortunately many clinics are more focused on profit than on identifying what is most suitable for the patient.

We all know what the industry is capable of. The world watched as pop star Michael Jackson turned from black to white. We saw how his nose changed shape and shrank towards vanishing point. There was a man who could afford the best.

Just as we look back with incredulity at tribes which extend their necks with rings or pierce their ear lobes with saucer-sized discs, will future generations gaze in horror at what women in our culture do? Will they gasp in disbelief at women having the skin lifted from their faces, the muscles tightened and then the skin spread back, stretched and trimmed all in pursuit of a beauty that as Fay Weldon rightly said, “is the first gift God gives a woman and the first he takes away”.

Eternal youth is what we all dream about. But is it worth risking our health to achieve a temporary half measure? Isn’t it an affront to be operated on by people who would not themselves take the risk? I think so.

Surely it’s better to learn to accept each phase of life as it comes. After all, when the reflection in the mirror becomes too unpleasant – we can always ditch the mirror.

So bring on the VAT. The challenge of finding that extra 20% when we’re all broke and getting broker, might save some of the most vulnerable from themselves.