Dr Sebagh the rejuvenator

We meet at 9am, which is late for Sebagh since his day started in Paris at 5am (he commutes between his two practices in Paris and London). He's a Sarkozy lookalike, full of energy and enthusiasm, whose working day, spent injecting the minuscule furrows and wrinkles of London's party set, ends at 8pm. He wears tight black trousers and black leather boots underneath his crisp green surgical top. He looks more Harley-Davidson than Harley Street but this macho stuff is part of the appeal. His office is decorated with all sorts of items that border on the garish, including a cushion embroidered with the words 'Docteur, Sculpteur, Magicien, Genie. Merci' given to him by a client. In fact the whole office would seem more appropriate in Essex with its in-your-face black and gold floral wallpaper and chipper assistants with big everything. He doesn't even try to hide his patients from one another as other doctors do. His client list is a sort of club. Being a Sebagh regular gives you kudos – it means you're in the inner circle and that money is no object. What the club is not so keen on is being photographed outside his Wimpole Street practice, lips oozing collagen, by the hovering paparazzi.

Sebagh only rests at weekends when he does yoga and Pilates to keep the stress levels down. I write 'STRESS' in big letters in my notes. After DNA and a bad lifestyle (smoking, sunbathing, et al) it's stress that ages us fastest, he says. 'The first thing anti-ageing doctors look at is cortisol levels. Stress has a biological effect. When stressed, you ride your adrenal glands and this ages you.' I guess he keeps his levels fairly low, given his flawless face, though I suspect a knife has been used as there is a Hollywood lack of flesh underneath his eyes, and, of course, lots of Botox, which he has been injecting since he was 39.

Dr Sebagh was brought up in Paris in the smart 16th arrondissement in an haute-bourgeois family; his mother, 'a very tough businesswoman', and father ran a super-market chain called Franprix. His sister (and occasional client) is, he says, 'the perfect Parisian housewife'. But Jean-Louis decided to become a doctor and then a plastic surgeon. For around 15 years, he worked to rebuild cancer victims' faces and heal burns victims' scarring in Paris's Hôpital Foch. In the early 1990s, he started coming to London every few months with injectables for a small group of fans that gradually grew until, in 1997, 'in a bad place personally' because of his divorce from the mother of his children, a Parisian dentist, he set up his surgery here, hoping to inject some 'fresh air' into his private life.

He and Amanda Eliasch, a socialite photographer who used to be married to Johan Eliasch, the Head sportswear mogul and green campaigner, were lovers for many years. I thought he would be as open about the arrangement as she is – a recent blog of hers reads: 'I went to see my old boyfriend, Dr Jean-Louis Sebagh, the famous face guru. I caught him having breakfast in his kitchen: rice cakes. He loves showing me how thin he has become, his six-pack is revealed. I need to go just to check my dodgy age isn't beginning to show on my face, of course it is, but at least, after five minutes, I leave feeling that I am once again restored to eternal youth.' But he is discreet: 'I am a double Virgo,' he says. 'I am naturally very discreet. I believe in la vie secrète, the magic box. You don't open it.' The two are still very good friends, but these days Sebagh is quietly involved with an Englishwoman who runs her own company and is keen to keep out of the limelight. I get the sense that he would rather not be a household name, at least when it comes to his sex life. 'In France we have a right of privacy. In Anglo-Saxon England, loss of privacy is the law. I'm not saying it's OK to cheat on your wife, but divorce is not an easy life.' His 19-year-old son, who is at Wharton School of Business in Philadelphia, and his 16-year-old daughter ('no Botox! She's perfect'), who is heading to California to study film, seem to have come out OK.

For all the hype, and there is plenty, Dr Sebagh talks a straight game. He claims he doesn't change faces but 'restores what you lost five to ten years ago. I am like a painter. There are artistic skills. Some people are talented, some are not. You don't learn how to do any of this in school. So many cosmetic doctors – do they have surgical skills or are they trying to increase turnover?' What Sebagh seems to have achieved is lessening the stigma once associated with 'having a bit of help'. It was Sebagh who apparently persuaded Cindy Crawford, both his patient and collaborator since he helped develop her beauty range, Meaningful Beauty, to go public. 'I'm not going to lie to myself,' she subsequently said. 'Past a certain age, in order to restore elasticity, all I can count on is vitamin injections, Botox and collagen.'

The best doctors these days combine Botox brands to keep a few frown lines and avoid the Spock-like arched eyebrow (a dead giveaway). A frozen face means you're in the hands of an amateur. 'You don't see the results when it's properly done,' he says. 'You have to understand my role. I am like a puppet-master. You have to play with expression. You don't just switch it on and off.' Botox is what made him famous 28 years ago. He now has 4,000 to 5,000 patients a year and turned over £6.5million last year from the Dr Sebagh Advanced Anti-Ageing Skincare range alone (his Supreme Maintenance Youth Serum, at £210, is a bestseller). He won't say what he earns a year but to give you an idea: Dream Sculpture, his new programme which uses Restylane or Voluma (an alternative to fat transfer), takes half an hour to administer and costs up to £3,000.

Of course, success brings its enemies and Dr Sebagh is being sued for £300,000 by a businesswoman called Nina Pustilnik, a former executive at both Warner Brothers and Sony Pictures, for negligence. She says she suffered undisclosed personal injuries following treatment she received at his London clinic three years ago. He denied it at the time. 'It is untrue,' he has said in the past. 'She is an old patient who had some treatment years ago. She had fillers, which are nothing. Now she claims she has had headaches, which is very vague. But there is no side-effect unless she can prove it. It's all allegations at the moment.'

The case is now sub judice. 'Zip,' he says theatrically. 'I am gagged.' He wants to tell me everything but his PR, hovering in the room, confirms that this is a no-go area. This doesn't stop him for long, though. 'Neurotic patients can be very dangerous,' he says. 'We are dealing here with fragile women. They're borderline and they jump. They might be depressed when they come. The train, as they say in French, might be hiding another train. They might have a little bomb. They might be delivering a package. It's very serious.' I think what he's saying is many of his clients are nuts. He says his goal is to be the go-between for his patients and the beholder. 'If a woman is just looking at herself in the mirror, we're in trouble. That's narcissism. She's looking for perfection. That's unattain-able. But most women want to be looked at by others.'

My theory is that the straight-talking Frenchman specialises in what these women never get: an honest opinion. Wealthy, spoilt, famous and vain, his clients are told from morning till night how gorgeous they are. Then they pitch up at his office and he says (bluntly), 'Surgery' or just 'No'. He recently turned away a dysmorphic patient. 'She sees things I don't see,' he shrugs.

He's already treating patients who don't need help yet. This is his new approach to beauty: get them young and then nothing will fall or flop. 'You can keep your 40-year-old face until you're 70,' he says. 'Obviously if you have a hyperactive face at 18 you will need Botox early.' Otherwise, he believes a woman should start in her twenties with procedures that stop the natural drop of time (such as Botox in the neck and lower face, to avoid jowls). Surgery is the last resort, he says, and only for those of us born before 1980.

Many of my friends see Sebagh and adore him, so he clearly does something right. His staff are amazingly helpful and everyone in the office seems to love each other – it's kind of sweet and not at all English. No indeed: 'Some British women are still hiding their treatments,' he muses. 'They feel a guilt about vanity that doesn't exist in France, or Moscow where I am doing more and more work. In Moscow, they love the injections, they want to look their best possible and enjoy life quickly. In Paris, they just think it is normal to take care of yourself; the only thing that stops every woman doing it is a budget problem. In America, surgery is a consumer commodity. But in the UK, women are still ashamed.'

The good news is he thinks the vitamin injections (£250), his long-standing concoction that his patients swear by, might help me. Thank God for small miracles.

Nina Pustilnik

Our interview on 23 April with Dr Sebagh noted that a clinical negligence action against him had been brought by Ms Nina Pustilnik. We quoted Dr Sebagh as saying that Ms Pustilnik suffered from 'headaches'. We have since learned that this is not an accurate statement of the medical facts at issue. Dr Sebagh also made comments about the mental state of many women to whom he supplies services. It was not our intention to relate these remarks to Ms Pustilnik and we apologise for any misunderstanding.