Under-eye bags big enough to carry your weekend gear? Crows’ feet, rabbit lines (on the nose), smokers’ lines?

What about muffin-top tummy or basement-level libido and energy? Or maybe tits/moobs going south, saggy bum or wattle (that’s a wobbly double chin)?

If you are bothered by any of these and want to understand more about the best way to banish the problem, high50’s Anti-Ageing Debate could help you. Dr Daniel Sister, an advocate for the scalpel and needles methods, will fight it out with our award-winning beauty journalist Jo Fairley, who favours the potions and lotions route. Interventions of a scientific kind will do battle with proponents of skin-deep solutions.

Dr Daniel Sister is a world-renowned hormone and anti-ageing specialist. He is a needles-not-unguents man who has practised for 40 years at many of the world’s premier clinics (including Dr Sebagh’s).

He has written several acclaimed books, is published in medical journals, has treated thousands of men and women, and regularly appears on TV. Phew!

His research studies and expertise are sought after by the beauty, anti-ageing, nutrition and complementary medical communities.

Science in the salon
Dr Sister works in London at BeautyWorksWest, a beauty clinic with slick, vibrating pedicure thrones and scented treatment rooms, where a client can go in as a sexagenarian and come out as a sex bomb.

When he started out in the Seventies, he worked in a hospital with rheumatic disease sufferers. “Most of them were are old and, in trying to help them, I got into anti-ageing treatments,” he says.

Salon-administered science appeals to the aesthete in him. He uses only methods that are approved in Europe and the States.

He believes in science-based interventions rather than snake oil and designer potions, and in tackling ageing from the inside out. “Everything I use has an evidence base,” he says. “It’s all backed by research and reasonable-size case studies.”

He finds new treatments by attending international conventions and seminars and quizzing other experts about developments in the field.

Hence le docteur (he is from France) has managed to introduce an incroyable seven anti-ageing ‘firsts’ to the UK market, including ‘Dracula’ (aka Platelet-Rich Plasma) therapy.

This treatment has attracted worldwide attention. Not surprising, then, that rather than flogging pots of nice-smelling creams, you’ll always find him talking about things like IPL or Radio Frequency, and Infra Red and Polaris; all designed to give if not quite eternal youth, then something not too far from it.

Needles over knives
He doesn’t do surgery. “I prefer needles to knives,” he says. “But I refer people [for surgery] when required.”

Mostly he thinks surgery is unnecessary. There has been such progress in the development of non-invasive treatments, and most procedures (from reconstruction to fat removal) can now be done non-invasively.

“Fat removal, for example, can now be achieved with ultrasound, laser and radio frequency,” he says.

He’s also a top doc when it comes to balancing hormones, one of the best ways to fight the ageing process. When our hormones are in balance, the body generates new tissue and more energy, and can fight disease. (A reduction in hormone production is the probable cause of the growing incidence of premature ageing.)

Dr Sister’s anti-ageing armoury:
YOUTH: pills to boost hormone production
His beauty and wellness products include YOUTH food supplements, which re-boot the production of the growth hormone in women d’un certain age (and old male bangers, too). If you want to get technical, YOUTH tackles ageing with Arginine, Glutamine and Lysine (amino acids and marine plant extracts, to the uninitiated), which promote skin radiance, sleep and energy levels.

Dracula Therapy: injections of blood, vitamins and amino acids
Dracula Therapy is his most popular full-throttle age-defier and uses the patient’s blood as an injectable treatment. A small blood sample is separated by centrifugation into red blood cells, clear serum and platelets. Vitamins and Amino Acids are then added to create a super-charged serum, which is injected back into the skin.

“There are no disadvantages,” he says. “Nobody can be allergic to his own blood. It’s efficient, proven, and the first step towards using stem cells.”

Dermal fillers: a new nose
He has pioneered non-surgical nose re-sculpting by injecting dermal fillers – gel-like substances that are totally safe – which gives a patient a new nose in ten minutes. He uses Hyaluronic acid – which is biocompatible with human Hyaluronic acid – to create ooh-ah faces and hands.

Injections of carbon dioxide and Botulin Tox
In Carboxy therapy, he injects Carbon Dioxide Gas (CO2) to tackle stretch marks, cellulite and dark eye bags.

It doesn’t stop there. He’s been doing surgery- free breast enhancement treatments for years, with Botulin Tox and injections, including super-charged plasma.

Lipo, light therapy and lasers
He also performs several methods of non-surgical liposuction. One of his fat- busting treatments (MELT) combines radio frequency, magnetic waves, ultrasound and light therapy and another uses a non- invasive laser to melt the F-word from within fat cells.

“Conservative” Brits
For those souls who think creams and serums are efficient, he has this to say: “There’s not one scientific study to show that they work, but many to prove that they don’t. There’s the ‘feel good factor’ – they feel good on your skin, but they don’t penetrate deep enough.”

Contrastingly, he can find no downsides to scientific intervention.

With so much being discovered in anti-ageing treatments, we’re on the brink of a brave, young world. He says: “Only five years ago, ultrasound and radio frequency weren’t even used. Each time we open a door, there are ten more [discoveries] behind,” he says. “There’s a lot to be explored with stem cells.”

The Israelis are pioneers in creating equipment for age-defying treatments. The gold for hormone therapies goes to the Americans. The injectable treatments medal gets scooped by the Europeans.

And the Brits? “They’re very traditional and conservative,” he says. “They don’t embrace the techniques fast.”

Which, paradoxically, is good news for high50 readers. Otherwise, Dr Sister wouldn’t need to thump his tub at the high50 Anti-Ageing Debate this month. And we’d miss out on deciding who’s right.

Jo Fairley, high50’s beauty editor, is putting her elegant neck on the line in defence of topical treatments. We salute Dr Sister for joining her there.

Everyone leaves there having made at least one change in their lives. That’s what I’m told about Kamalaya health spa in Koh Samui, Thailand. Guests rid themselves of multiple pounds (in weight and currency), have a turn of direction in their heart-attack-headed lives, and rejuvenate bodies more burnt out than a forest fire.

The hottest trend in travel is to invest in your body. And Kamalaya, one of the world’s leading destination spas, is the place to do it.

It offers healing hands aplenty and Eastern traditions alongside the best of the West, including state-of-the-art diagnostic procedures. This translates into diverse healing and spiritual approaches: a holistic combo that is targeted at the mind, body and soul.

There is a crack squad of practitioners, encompassing traditional Chinese medicine, naturopathy, homeopathy, Ayurveda and energy healing, as well as registered nurses, an allopathic doctor, Thai therapists and visiting guru types.

Shoulders and chakras
I’m at Kamalaya to release shoulders that have more knots than a yacht covers in a storm, to catch up on several lifetimes of deprived sleep, and perhaps to buff my soul and open my chakras. My companion, my Ritalin-filled 17-year-old nephew Henry, wants to find alternative approaches to his ADHD (or rather, that’s what his mother wants).

The location on its own starts the healing process. The spa is on a hillside of swaying palms and tropical foliage borrowed from a Gaugin painting. It sits beside a crescent-shaped beach and an aquamarine lagoon. It’s a Garden of Eden with plants that probably talk, lotus ponds and ginormous orange butterflies

There is a herbal steam cavern hewn into the rock and a Buddhist monks’ cave. It’s a close to heaven as you can get while still alive.

Who’s here…
Here you’ll find the likes of Annie Lennox, Oliver Stone (who lost more than a stone), stressed-out investment bankers and ladies who don’t lunch. There are singletons who meet at the dining table for singles, and couples on a health kick. And the hard-core detoxers whose treatments include the dreaded colonics.

Then there’s the founders: Karina Stewart, a doctor of traditional Chinese medicine who also trained in anthropology and wafts around on a spiritual cloud dispensing healing energy; and her husband John, a yogi who devoted 16 years to spiritual studies in a Himalayan community.

…and what they’re doing
The spa offers 70 treatments and programmes, from weight loss to yoga. The latest is the sleep programme, using naturopathy and Chinese therapies to take people to the land of zizz on a buckwheat pillow.

Days are also sugar-free-jam-packed with activities, from aqua aerobics to mediation and Qi Gong. Recalling a meditation session at Kamalaya, Fergie, the Duchess of York, wrote in her memoir: “We sat cross-legged on mats around the fire, with everyone chanting Om.” Bring on the incense, bruv.

The food is organic and fresh, combining ancient Asian healing traditions and the latest Western nutritional research, and including diets derived from Ayurveda and naturopathy. The precept is that when the diet is wrong, medicine is of no use; and when the diet is correct, there’s no need for medicine.

The chef works from the belief that we are much more than what we eat – but that what we eat helps us to be more than what we are. It’s to this end that the mini-bar contains roasted pumpkin kernels and aloe vera juice.

My programme starts with a body bio-impedance analysis (which measures body composition electronically and rudely informs me on a printout that I’m a little overweight) and after which I have a delicious meal. Black cod and banana blossom salad, where have you been all my life?

I also have a wellness consultation with a naturopath, magic-handed massages (including Chei Nei Tsing, a Taoist tummy massage), and nutritional advice. I spend a particularly interesting hour with Smitha Jayakumar, a one-time Buddhist nun who lived in a monastery for ten years and is now a spiritual life coach.

All the treatments work on an energetic, emotional and spiritual level. But does it do the trick?

Well, yes and no. I am shadowing Henry (in the interests of journalism and at the instruction of his mother) and writing articles. So I don’t really experience the essential switching-off element of the programme.

But by the end there’s definitely a spiritual spring in my step and a luminescent quality to my face. Not to mention a trimmer body, achieved partly by so often climbing the hill to the dining area and treatment rooms.

Some people say they leave Kamalaya with reignited spirits and hearts, and with more than Band-Aid to deal with their wounds. We leave feeling healthy, happy and relaxed. (So that’s more than one change in our lives, then.)

Most spas claim to make you feel well; Kamalaya actually delivers. It does what it says on the tin. And more.

If I said ‘menopause retreat’ to you, what would you imagine? Something involving California, teepees and chanting, probably. But no, I am at Grayshott Spa in Surrey, convening for a five-day break.

Although this solid country mansion has something of the air of a sanatorium about it, it is surrounded by 47 acres of lovely green stuff, mature trees and bunnies. Alfred Lord Tennyson shacked up here (and that was before they had an open-air pool).

Now, the rooms are traditional-lite, their mini-bars stocked with nothing but water (but you can sneak out to the farm shop just across the road). And if the food is a bit Good Housekeeping, the atmosphere is quite ‘Om’ enough for the experience ahead.

It is to avoid a different experience from one that previous generations have had to suffer that we’re undergoing this.The number of women in the world who have passed their 50th birthday is expected to rise dramatically from 467 million in 1990 to an estimated 1,200 million by 2030. This figure – caused both by population increase and prolonged life expectancy – means that many of the women will spend more than a third of their lives beyond The Big M. In other words, post-menopause.

What happens to the body
During menopause, oestrogen production declines, leading to a reduction in bone density and an overwhelming list of possible symptoms. These include hot flushes, night sweats, interrupted sleep, headaches, bad breath, bloating, mood swings, loss of confidence, depression, heart disease, dementia and loss of libido.

It is no surprise that, for many, the menopause blights lives. And women are often not sure where to find support.

At Grayshott Spa, the Menopause Retreat addresses the problems of this major life change. The course leader is women’s health pioneer and nutritionist Maryon Stewart. She is a formidable lady who started the Angelus Foundation, which educates people about the risks of ‘legal highs’.

She is a mother of four, author of 26 books, a prolific broadcaster, a counsellor, the founder of a women’s health advisory service and proponent of alternative healthcare. Additionally, she’s a pocket Venus who can do the splits (but only after she’s warmed up).

Seeds and beans
Maryon has devised The Natural Menopause Kit, a scientifically based approach. Before the retreat, you are asked to complete extensive paperwork about your diet, symptoms and medical history.

Once you’re at Grayshott, the retreat kicks off with dietary advice. You need the right nutrients for optimal hormonal performance, otherwise you’re conducting the orchestra with one hand. Some plants (soybeans, red clover, linseed and, in much lower quantities, green tea, peas, pinto beans and lentils) contain naturally occurring compounds called isoflavones. These closely resemble the molecular structure of oestrogen and act as phytoestrogens (i.e. like oestrogen in the body).

The idea is that if you take the right amount and right combination of isoflavones, the body will be fooled into thinking that the ovaries are still working. If you get enough of it into your receptor sites, you’ll replicate your pre-menopausal state, thereby averting/reducing/killing your symptoms and potentially protecting the long-term health of your heart and bones.

Almost immediately, we ladies on the retreat get to sample the delights of naturally occurring oestrogen: pumpkin, sesame and flax seeds and enough soya to feed an army. It might be with a slight tightness in our voice that some of us say, “Pass the spiced poached pear with tofu,” as we’ll have already been given a Body Composition Analysis in which we stand on a metal plate and a nasty machine gives us a printout revealing whether we’re too fat.

Maryon teaches us about the foods that aggravate menopausal symptoms. These include spicy foods, alcohol, caffeine and hot drinks. Instead, we should go for those oft-recommended treats, mackerel and green leafy vegetables.

Your nutrient levels
She might suggest having your levels of nutrients, vitamins, mineral and biochemical levels measured at Biolab in London – the only laboratory in the country doing tests of this kind– to determine any deficiencies that need to be addressed nutritionally or by other non-drug means.

Once the results are revealed, she can tinker and add to the supplements she has already recommended; Red Clover or Sea Buckthorn Oil, for example. She doesn’t use anything unless it has been given the thumbs-up by the men in white coats.

But life according to Maryon is not just a question of pill-popping and glugging soya. She offers a smattering of DIY spiritual tips (of the ‘make gratitude lists’ and ‘capture the joy in the moment’ ilk) and there is something in the way she lives her life that make these extra attractive.

Importantly, she also suggests various changes in lifestyle. Exercise is a crucial component of the programme, so you’ll be expected to spring out of bed before breakfast to do aqua aerobics and take walks, sweetened only by the latter being across the beautiful National Trust acres that adjoin Grayshott.

She is also keen on ladies d’un certain age having at least 20 minutes of relaxation a day. It is proven to reduce night sweats and hot flushes. The latter, incidentally,arecaused by the body trying to kick-start the ovaries, rather like an engine being revved when the gear box is broken.

Now this is where you get to the ahhhh bit of the retreat: the relaxing massages (often from talented menopausal therapists), yoga classes and use of the Pzizz machine, which plays hypnotic, relaxing, sleep-inducing soundzzzzz.

Not on the scrap heap
One of Maryon’s aims is to help women come off – or avoid going on to – HRT, with its possibility of breast tenderness, bloating and headaches, and potential health risks including breast cancer.

Her programme has been proven in two studies (conducted over five months, with 50 and 100 women respectively) to help more than 90 per cent of women wean off HRT and overcome their symptoms naturally.

Her overriding message is that women can be more in control of their health prospects, rather than feeling on the scrap heap, as some do once they reach ‘The Change’.

You may not like the soya worship. And eating isoflavones to combat nature’s joke is not a new approach. But, ladies, the menopause isn’t a problem for Japanese women, whose diet is high in such foods, especially soya. So it’s worth a try.

Either way, you’ll finish the retreat with a greater understanding of how to look after your ageing body, mind and soul. You may not feel as good as Cherie Lunghi, who reported feeling “500 per cent better” a few months after doing it. But you’ll leave with hope, supplements and the promise of a renewed libido. A good enough alternative to going downhill?