Madonna in facelift riddle

By now, of course, we should have wearied of Madonna's endless capacity for re-invention. What a clichè the remaking of her image has become as, year after year, she has struggled to keep the public intrigued.

But for all that there was something shockingly different about her appearance at the Grammy awards on Sunday night. This time, it wasn't her usual gimmicky splash of fancy dress (a flashed breast, a pretend punk ensemble). Nor was it as vulgar as the 'lesbian' show which she put on with Britney Spears at the MTV awards last year.

Instead, Madonna appeared to be showing off (whisper it) a new face. Well that, at least, is what music industry gossips have insisted since Christmas, when, it is said, she visited a plastic surgeon in Los Angeles and had a 'very subtle and high quality' facelift.

Her appearance at the Grammys was the first chance for everyone outside her immediate circle to judge if the stories could possibly be true.

At 45, many of the well-heeled women in LA are on their third or fourth procedures, so there would be nothing outlandish, in Hollywood terms, about Madonna getting her face tweaked. And talk of her using Botox injections has been widespread for some years now. Sources in New York even claim to have spotted Madonna in town carrying a bag marked The Brandt Clinic, famed for its Botoxing.

Last year, it emerged that she'd been having non- surgical beauty serums blasted into her skin at a small salon in Hampstead, North London, for £350 a time. She is also a fan of Linda Meredith's Crystal Clear Oxygen Facials and Dr Hauschka creams.

But a surgical facelift? Would Madge have gone that far to keep up with today's divas?

Surely she cannot hope to catch glorious, golden Beyonce, only 22, whose single Crazy In Love outsold Madonna's effort, Hollywood, last year by a ratio of two to one, and who walked away on Sunday with five awards, the acknowledged queen of this year's event.

Certainly, it appeared that Madonna had conceded defeat to the new generation of upstarts when she launched herself as a children's author last summer, all hornrimmed glasses and demure frock.

And with a flop album (American Life), two flop singles (American Life, Hollywood), a flop film (Swept Away) and a particularly embarrassing ad campaign under her belt (Gap), it appeared she was finally ready to leave the stage for a new generation of pop stars.

On the evidence of the Grammys, though, the truth is very different. It must be said that under the lights at the Staples Centre, the age gap was not at all apparent: Madonna looked every bit as good as the young pretenders.

There was no hint of sag about her jowls, nor a line on her neck. Where most 45-year-olds might expect to find the unwelcome beginnings of a double chin, Madonna had the defined jawline of her friend Gwyneth Paltrow, who is a decade her junior.

Ozzy Osbourne's wife, Sharon, is firmly in the camp which believes that Madonna's seraphic new image is down to some kind of medical intervention.

Never one to call a spade a garden implement, she gasped: 'I tell you what, I went into shock at Madonna's new head. See, she's got that Botox in that forehead. Oh, Madonna I know what you've been doing! There's not one line on that bloody head!'

I asked Mr Aposotolos Gaitanis, plastic surgeon at the Harley Cosmetic Clinic in London's Harley Street, for his opinion. 'Madonna has a very well-proportioned face, with high cheekbones, a high forehead and a well-defined jawline,' he said. 'I suspect she has been enhanced by cosmetic surgery.

'Her jawline looks less "soft" and better defined than in some earlier pictures. This may have been done with a "mini lift", which involves the tightening of over-relaxed facial muscles and the removal of excess skin.'

And then there was the mystery of Madonna's cat-like eyes - with no hint of crinkle around them. Poor Geri Halliwell, who is 14 years younger than Madonna, looked more wrinkly than she did.

Back to Mr Gaitanis. 'A woman of 45 would usually have loose skin around this area.

'Madonna's top eyelids appear to have no excess skin whatsoever. This could be due to an eyelift or brow lift, which involves the skin of the brow being pulled and muscles beneath tightened by keyhole surgery.

'Madonna's complexion is also excellent. She obviously looks after her skin, and she may even have had a glycolic peel to remove dull cells and reveal her healthy, radiant skin.

A peel may also account for the fact that she does not seem to have any lines around her mouth, which is unusual for a woman of her age. Or she may have had them filled.'

But when asked about the possibility of plastic surgery, Madonna's spokeswoman, Barbara Charone, was perfectly clear on the subject yesterday. 'Absolutely not!' she said. 'She's not had anything done.'

Such a vehement denial seems at odds with a sentiment Madonna herself expressed in September. ' I am certainly not against plastic surgery,' she said. ' However, I am absolutely against having to discuss it.'

More recently, however, she was more dismissive, saying that her new-found Kabbalah spirituality allowed her to focus more on the virtues of infinite compassion and unconditional kindness than the undignified scramble to be the fairest of them all.

'Every once in a while I see a little wrinkle on my face and I go "Bummer". But I'm not going to get caught up in thinking you have to stay eternally young. I am what I am. And I don't like the idea of someone putting you to sleep then taking knives to you.'

She even spoofed the idea of surgical intervention in her Hollywood video, in which she was shown pretending to have Botox injections.

It would surely be too brazen then - even for Madonna - to go back on her word and have her face done. Wouldn't it?