A magazine says this heart shape is the perfect face for the 21st century. So can those glowing, rejuvenated looks, plump cheeks and supermodel cheekbones really just be the result of healthy eating and exercise, as so many A-listers claim?
The image is a stunning one - Madonna's face criss-crossed with telltale plastic surgeon's lines and notations, splashed across the cover of the latest issue of New York magazine, under the headline 'The New New Face'.
The cover story goes on to suggest that new developments in cosmetic enhancement are helping middle-aged A-listers turn back the clock - and leaving them looking eerily similar to each other.
To back up their argument, the article cites other stars who have 'New New Faces', such as Demi Moore, Michelle Pfeiffer, Liz Hurley and Naomi Campbell, who all boast the same winged cheekbones, smooth foreheads and absence of under-eye hollows, though there is no suggestion any of them have had cosmetic treatments.
While there's no suggestion Madonna has had cosmetic work, her face represents the modern ideal of beauty, as described above
While there's no suggestion Madonna has had cosmetic work, her face represents the modern ideal of beauty, as described above
So what is the New New Face, how are women getting it, and can those glowing, rejuvenated looks, plump cheeks and supermodel cheekbones really just be the result of healthy eating and exercise, as so many A-listers claim?
Certainly, at the beginning of the year, photographs showed Madonna with her face apparently bruised around her eyes and cheeks. Yet when she appeared at the Cannes Film Festival in May, she looked, well, simply amazing.
Alarming: Madonna's face, pictured outside a Kabbalah meeting in New York last week, further fuelled speculation she had gone under the knife
Alarming: Madonna's face, pictured outside a Kabbalah meeting in New York last week, further fuelled speculation she had gone under the knife
We marvelled at those Mount Rushmore cheekbones - wider and plumper and sculpted like never before.
That jawline, so narrow and tight. That supersmooth forehead. The plump, juicy quality that this superskinny, worked-out and half-starved 50-year-old had previously seemed to have lost for ever.
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So how did this look come about? Once, there was a time when - as Mae West put it - every woman had to choose between her face and her figure.
And with their four-hour gym sessions, Pilates, Hot Box yoga and 800-calorie-a- day, carb-free, macrobiotic diets, Madonna and her peers seemed to firmly favour their figures.
Their bodies were tiny and taut: their faces, meanwhile, got more and more gaunt.
Plastic surgery could deal with sagging, and Botox with wrinkles, but the hollows of age seemed inevitable. Until now.
In the past decade, intensive research into new ways to lift the face has led to remarkable advances which mean that surgeons can now effectively rejuvenate a woman's face from the inside out with injections.
Plastic surgeons had seen that skin tightness - the holy grail of old-style surgery - simply didn't make women look pretty or sexy.
Yes, the old-fashioned surgery brigade (think Joan Rivers) didn't have jowls or eyebags on their stretched, skinny faces, but they still looked old.
So a new method has been developed which means women don't have to go under the knife - and they don't end up looking as though they are standing in a wind tunnel the whole time.
The answer, according to scientists and doctors, was volume. Volume in the female face, it seems, is the very essence of youth.
AND THE OTHER PERFECT FACES
Angelina Jolie, left, and Demi Moore, right: Perfect faces?
Hollywood beauty Michelle Pfeiffer has the desirable high cheekbones, while Elizabeth Hurley, right, is another actress with a 'perfect face'
In the 1990s, Dr David Perrett, of the University of St Andrews, began studying perceptions of beauty, compiling composite photos of European and Japanese faces and asking people to judge them.
Dr Perrett found that his beautiful faces had something in common.
'The more attractive ones had higher cheekbones, a thinner jaw, and larger eyes relative to the size of the face,' he says.
Then, in 2005, top UK consultant plastic surgeon Rajiv Grover investigated the relationship between face shape and beauty - and defined the 'angle of beauty' as 81 degrees between the centre of the chin and the outer edge of the cheekbones.
The cover of the American magazine that has revealed the so-called 'perfect face'
The cover of the American magazine that has revealed the so-called 'perfect face'
This gives a heart-shaped face like that of Kate Moss or Michelle Pfeiffer.
In other words, beautiful faces are heart shaped or Y-shaped - widest at the cheekbones, and plump and juicy, like peaches.
The shape is important because studies monitoring eye movements show that is the first thing we notice about each other. We focus on a small triangle from the top lip to the outer corners of the cheekbones and the eyes, and only then, and briefly, look at the general contour of the face.
A separate study last year from an American plastic surgeon finally revealed exactly how we lose that vital, youthful, facial fat.
First it goes from around the eyes, next from the upper cheek, then from cheekbones, the sides of the mouth, the nose-to-mouth lines, and finally from the forehead and sides of the face.
The result? Instead of a perky, curvy heart, you have a flat rectangle.
The effect of these studies on the beauty industry was electric, with a slew of new so-called 'fillers' hitting the market.
Brand leader Restylane launched SubQ, a hyaluronic acid filler which could plump up sagging cheeks for up to a year.
French doctors tend to prefer Surgiderm, a similar hyaluronic filler which is injected deep into the skin, right on top of the muscle, to create killer cheekbones and leave the jawline looking tighter.
Combined with a lower facelift and perhaps a little 'laser lipo' to whisk away any last traces of sagging and double chins, this is the essence of the New New Face.
Doctors are now developing techniques to produce the best 'New Face'.
In London, for example, Jules Nabet uses Surgiderm to perform The Y Lift - which seeks to give the patient that heart-shaped look.
At Nabet's clinic in Kensington, models, actresses and ordinary working women are queuing up to try his £2,000 treatment.
Using a special fine canula to deliver filler deep into the face, in just 20 minutes and using four injections, Nabet can boost cheekbones and wipe away five to ten years.
'It is the biggest change in cosmetic surgery in a decade,' he says. 'It means there is no longer a need for surgery as the results are so revolutionary and not at all traumatic.
'In terms of Madonna, it certainly seems possible she has had work done. I would say it could be a procedure like The Y Lift.'
Sought-after: Demi Moore (L) Ashley (C) and Mary-Kate (R) Olsen's facial features are popular with surgeons
Dr Jean-Louis Sebagh, meanwhile, whose clients are said to include Trudie Styler and Madonna herself, uses the French filler Voluma for his new technique of 'Dream Sculpting' - an injectable facelift which takes just 30 minutes, costs £800 and lasts up to 15 months.
These new injectible facelifts can be maintained with annual visits to a cosmetic doctor. And with minimal bruising, no stitches and no scars, the New New Face is achievable with the utmost discretion - which is vital to celebs under the paparazzi's gaze.
Of course, there is a price to pay for this pursuit of perfection. Injections, no matter how skilfully done, hurt.
I myself had cheek enhancement a year ago and found it pretty uncomfortable despite having my face frozen with dental anaesthetic.
And while the long-term result was good, I was swollen for a few days and looked remarkably like Madonna in those recent unflattering make-up free shots.
The danger is that in search for the New New Face it can be all too easy to lose sight of where subtle enhancement ends and freakiness begins. And that's not youthful at all.