Rivers run shallow for Joan

Stare at Joan Rivers's face long enough and it starts to seem perfectly normal: the taut skin, pale as uncooked chicken; the snubby nose sculpted to the width of a lollipop stick; the black eyes in sockets so deep you wonder if she suffers from tunnel vision.

She will be 70 soon - no one is sure of her exact age - but she is putting up a fair old fight against unwanted wrinkles and pouches. She visits her plastic surgeon regularly. Sometimes, he tells her to hold fire; sometimes, he books her an appointment.

"My schedule is far too full for me to have had as much surgery as everyone thinks," says Rivers who, unlike most of her showbusiness colleagues, couldn't give a fig that everyone knows what she has been up to. "Still, every so often I ask my doctor: 'Whaddya think?' The last time I had something done was two years ago. My face is very thin, so they filled my cheekbones, and I was getting a turkey neck, so they did that too." I peer at her, looking for seams. Where did they put the stuff in? "I don't know, and I don't ask."

Joan has no patience with people like me, who think all this nipping and tucking is a bit disturbing and, well, shallow.

"You don't like your big, stoopid nose? Then get it fixed, especially if you are making $20 million a picture. We're living in a society where all that counts is looks. What is Paris Hilton (the party girl and hotel heiress) famous for? Being blonde and rich - in that order. Why kid ourselves about it? I have a cousin and, for her birthday, I gave her a set of caps for her teeth. She's so happy with them. Well, great!"

Rivers is in London to do another four performances of her stand-up act and she is staying at the Ritz. We are talking in her suite as she prepares to make an appearance on the Graham Norton show (she shows me the copious notes she has made so that, when the camera rolls, the jokes will follow, rat-a-tat-tat). Thanks to her jewellery and skincare ranges, which she sells on the shopping channel QVC, Rivers is a seriously rich woman. So, why does she bother putting herself through the stress of live stage work? Why doesn't she just lie in bed, eating rose creams?

"I do it for love - and money," she says. "I'm the only performer in the history of showbiz who never owned anything, and I support every third person in New York. At funerals, people stand their children next to me because they know that, in a moment of weakness, I'll take care of paying for college. A lot of lawyers and doctors will tell you aunt Joan has been good to them."

But she still gets nervous. "Will they like me? Won't they like me? On stage, I need that first laugh that tells me I'm with friends."

She is, she says, always on the side of the audience - which is why her bitchy fashion commentaries on award shows like the Oscars are such a ratings winner (she does them for an American cable channel called E! and makes mincemeat of the competition).

"My allegiance is to you at home. You're sitting there and you've just said to a friend: 'Ugh! I hate that colour.' If I come out and say how lovely it is, no one's gonna watch." So, she isn't softening in her old age? "Oh, no! God forbid. I'm not a nice old granny." Besides, secretly, the celebrities love the attention. "The more you talk about them, the more they like it. What do we remember about the Oscars? We remember Cher in that insane hat, Courtney Love in a garbage bag, Björk dressed as a swan. Cher was once very angry about something I said, but she was even angrier when I took it out of my act. She came backstage and asked me why she'd been dropped. The smart ones get the joke. Sarah Jessica Parker always wears funny shoes. She'll come up to me in some amazing dress and then she'll point at her feet. I say: 'Don't do this to me.'"