The secret surgery guru is tight-lipped about client list

Shannon Leeman — who describes herself as an ‘anti-ageing consultant’ — helps celebrities to deny their age by advising them of the cosmetic procedures and surgeries needed to tune up their particular looks. She knows whose noses have been tweaked, whose lips have been contoured and whose boobs have been inflated. But her lips are sealed

My phone rings at 2am. An A-list actor in Los Angeles wants to talk. He is anxious - his jawline is looking slack and he's getting a double chin. What can he do to fix it? We discuss a subtle neck lift and some mini liposuction. He wants the best. Will I set it up - under a false name, of course? (We call it a double file.)

A leading actress skypes me from the set of her latest film. She has seen herself close up in the raw footage and is panicking about the lines around her eyes. I suggest some fast laser treatment and arrange for my favourite aesthetician to meet her in her trailer.

I have a consultation with a singer. Her stylist has picked a strapless Versace gown for her to wear at the Grammys, but it is not fitting well. What can she do? I tell her about the Kybella injection that melts away fat around the armpits.

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The treatment takes eight to 12 weeks to work, so she has time. She's also considering a fat transfer from her waist to her butt to amp up her curves. Will she have time to recover from that procedure too? Her agent will send me her tour schedule.

I am flown to St Tropez to meet a CEO on his superyacht. His wife is unhappy with her breasts. She has lost confidence wearing a bikini. I suggest she meet Louis Benelli, a surgeon in Paris, famous for the shape of his pert, neat lifts known as the "coupe de champagne".

While I am there, the executive asks me to book him into a clinic to address his thinning hair and whispers to me, who is the best guy to take care of his moobs?

If asked my profession, I call myself an anti-ageing adviser. What I really am is the best-kept secret of the rich and famous. At a time when there have never been so many anti-ageing procedures, people hire me to tell them where to get the best, and to hold their hand through it.

And secret I am. Often I'll walk into a restaurant or private members' club in London, Los Angeles or New York and bump into a client who will pretend they don't know me. I recently spent months preparing a big Hollywood agent to look his best at his 50th birthday party, but he didn't invite me. My clients send me fabulous thank-you presents - theatre tickets, designer handbags, flowers, chocolates - but it is their PAs who sign the cards.

Among friends, however, I am a popular lunch date. I've done many an on-the-spot consultation in the loos in Annabel's, Morton's and Claridge's. One was while beating on a pheasant shoot. But usually the way I work is this. First I'll get a call from a PA who says: "My client would like a meeting." This is either at my South Kensington home or their home or via Skype. Sometimes I won't know who requires my services until they arrive. When they walk in I try not to do a double-take if they are very famous.

block_quotes_start At least a quarter of my clients are men. They come about their hair, jawline and waistline. Since the recession I have seen a lot of men afraid of losing their edge at work block_quotes_end

Then I like to guess their issue before we begin. But often I am wrong, which has taught me not to make suggestions. If someone asks me what, on their face or body, I think they should fix, I tell them that is for them to decide.

My job is to make sure that they get the best results and that they are safe. Often my consultations are like therapy sessions. We look in the mirror, do a lot of talking. Clothes come off. Then I present the options. If a client wants to go under the radar, I set up after-hours appointments in my name or arrange for a surgeon to come to their home.

I am not cheap. An hour's consultation costs £415 (about R7,350). If you have me on a retainer, we are talking thousands of pounds a month. But for many of my clients, their appearance is their most valuable asset. If they mess that up, everyone will be talking about it. My clients want to be on the "best-dressed" lists. They don't want to be the poster child for plastic surgery.

Not all my clients are in Hollywood. I see people from Europe and the Middle East - heads of industry and their wives, girlfriends, mothers and daughters - but also people who have saved for years. Requests include everything from Botox, fillers and laser work to nose jobs, breast lifts, fat reduction and gynoplasty.

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At the moment it is all about cheekbones - everyone is using fillers to re-create that roundness of youth. Lips are big too. You can accentuate the borders and get that little bit at the front plumped up to give you a pout.

Many women ask me how can they get rid of the creases on their upper lip - I call them "barcodes". I usually suggest a combination of treatments, including dermabrasion, lasers, fillers and freezers.

In America the non-surgical nose job is the new big trend. Dermal fillers are used to straighten areas of the nose or correct a hooked profile or tip projection. In 10 minutes you can have a new nose. It's a good way of trying one - it lasts only a year - before buying a permanent surgical solution.

At least a quarter of my clients are men. They come about their hair, jawline and waistline. Since the recession I have seen a lot of men afraid of losing their edge at work. They sense younger men biting at their heels and they want sharp jawlines and a full head of hair to look young and vital again.

Then there are the brides-to-be who want a confidence boost before their big day. We say, right, we've got six months until your wedding, this is what you want to do, and we'll make a schedule. I call this my "pre-nup and tuck" service.

block_quotes_start Many doctors are now using a device called the Keller Funnel, which allows them to squeeze an implant through a smaller incision than previously. The scars are minimal and there is less chance of infection block_quotes_end

For some, being given the options is enough. Others want hand-holding through the process. I go with them to their first appointment to make sure they are not being pushed into anything. Top cosmetic doctors are running multimillion-dollar businesses, so they may not be what I would consider impartial. It's not uncommon to go in for Botox and find yourself facing a laser machine. I never take commissions from clinics or doctors. My clients have to trust me 100%.

If they are having surgery I sit in on the operation, I am there when they wake up, and I take them home. I arrange bodyguards, chauffeurs, a 24-hour nurse, a chef. I call in therapists to do lymphatic drainage, light therapy, aromatherapy to speed up recovery, and makeup artists to hide scars. If you have had surgery, you have to lie propped up (unless you've had work on your butt). My pillow arrangements are a thing of beauty.

I have also set up at-home gyms. One client asked me to build a refrigerated storage room for her cosmetics. It looked like a well-stocked department store. A British actress hired me to build her a panic room with flattering lighting in case there was a break-in and she got stuck in there.

One actor's wife asked me to organise a video cam in their dressing room so she and her husband could film themselves from every angle before setting foot in public. It also served to catalogue their outfit combinations so they didn't repeat anything.

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I make it my business to know the experts. There are two great guys in London for breasts - Patrick Mallucci and Adam Searle. Miami is the place to go to for lipo, breasts and bottoms. There is an eye man in Palm Beach I love, one in Paris I like and one in New York.

When it comes to nose jobs the best guys are in Los Angeles - there is a doctor called Raj Kanodia who has done everyone. But if you want a strong nose, I'll send you to a fellow in Paris. If it's your first time doing your lips, I'll send you to Tracy Mountford in London, who I know will take her time. For regulars, the queen of lasers and fillers is Dr Rita Rakus.

I travel worldwide to the big cosmetic surgery conferences, where I watch hundreds of demonstrations. I sit in operating rooms observing, filming and asking questions. Cosmetic surgery is a gory, surprisingly rough business. The first time I watched an operation I clung to the wall to stay standing. Now I have my own scrubs.

The top doctors consider themselves to be gods and they love to talk about their work. Last month I filmed a Beverly Hills surgeon called Dr Ashkan Ghavami, who does a "a flash recovery breast augmentation". It took 17 minutes.

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Within half an hour the woman was up off the table, in her clothes, swinging her arms around (normally after breast surgery you can't raise your arms) and out of the door, with almost no pain medication and almost straight back to work. I had never seen anything like it.

Many doctors are now using a device called the Keller Funnel, which allows them to squeeze an implant through a smaller incision than previously. The scars are minimal and there is less chance of infection. It's a beautiful thing.

In the US, fat transfer is very popular now. Surgeons suck the fat out of one area with a cannula (a thin tube), then inject it into another with a giant syringe. Thanks to the Kardashian aesthetic, people are queueing up to take the fat out of their waists and put it into their butts.

So where do I stand personally on all these procedures? First, I'll tell you what I don't like, and that is brow lifts. A plastic surgeon will cut along the top of the hairline and pull everything upwards. I think the results often look terrible. You can end up with Spock eyebrows and a permanent look of surprise. I tell all my clients: if the issue is sagging eyelids, don't think about a brow lift, just do an eyelid lift.

In my view, less is more. You can go from Primark to Prada with just a few changes to your accessories. Whiten your teeth, straighten them, have a smattering of Botox, zap away fine lines and sunspots with a light laser treatment. These are all non-invasive procedures.

My most important advice is: don't scrimp or seek out bargain offers. Cosmetic surgery is a scarily unregulated world. Do your research and if you can't afford the best, save until you can. Think of your appearance as akin to your life savings.

Would you hand all the money you had to a cowboy or invest it in a scheme that you have read about on the back of a magazine? No. Hopefully you would go to a specialist who has a track record of protecting assets. The same goes for your appearance. You deserve to look your best, whatever your age.

- ©The Times, London