HERE'S the big difference between women turning 40 in the Noughties and turning 40 a decade ago: the question we all have to confront is, "Work or no work?" And you know I'm not talking about career versus early retirement.

Five years ago, if you'd asked what we thought about Botox, we'd have said "whatox?" or snorted with derision. Ask us now and we mutter darkly about the pressure created by our procedure-happy sisters.

The Western world's attitude to ageing has changed dramatically, and none of us has escaped the consequences. Even if you stand firm and let nature take its course, there will be plenty of friends and colleagues who have no intention of doing likewise, so the landscape of ageing has changed forever.

Now we're entering a new and crucial phase, when the new rules are being established: how real women, as opposed to Cher, should age. What we genuinely want to look like when we're in our 50s. And the interesting part is that the consensus is not what you might think. The backlash against the plastic pursuit of youth has begun.

We've already had the first confirmation that our love affair with anti-ageing procedures has hit a wall. Earlier this year, the American Society of Plastic Surgeons announced that facelifts had fallen off the list of the top five cosmetic treatments being requested in the US.

This doesn't mean American women have gone back to putting their trust in soap and water and plenty of sleep, but it does mean they are being turned off by extreme surgery - the facelifts that give you those cat's eyes and baboon cheekbones, that telltale tautness and captivated expression. Fake is fine, but nobody wants to have a face, or body, that can be totted up in terms of hours spent on the operating table.

Elsewhere, there are signs that the worship of youthful looks in fashion may have run its course. Karl Lagerfeld, who can always be relied on to scent the first whiff of change, has already declared his position on the subject. When the rumour was circulating recently that movie starlet Lindsay Lohan might be the new face of Chanel, his response was: "I prefer Nicole Kidman and that generation at the moment."

He has also come out as a Camilla Parker Bowles fan - "She is the life of the party. She's sparkling, she's witty" - while her younger predecessor, Diana, he dismissed as "pretty and sweet, but she was stupid".

So are we on the verge of rejecting the cosmetic advances of the past decade, or are we just pulling back a little on the throttle? The answer lies with the Hollywood women for whom this is a real and pressing issue: to boldly go the Brigitte Bardot route or to call in the anti-ageing specialists.

There has been some significant movement in the Hollywood camp. Teri Hatcher, the classic example of the too-thin, too-worked-on older female star, announced recently she was laying off the procedures and regretted those she'd already had.

Jennifer Aniston, when accused by a former flatmate of having had a nose job, rushed to deny ever having had any work. And Sharon Stone, on the publicity tour for Basic Instinct 2, deliberately made her age (48) and her pleasure at being that age, the talking point of the movie.

Now this is Hollywood, so it's all about degree. Nobody is suggesting any of these women rely on good underwear and light-reflecting moisturiser alone. But the key is they no longer subscribe to the Demi Moore "make me over in the image of my younger self" philosophy.

Even in Beverly Hills, they have felt change in the air. Age still scares us, but the market for blemish-free young looks has been spoilt by too many liver lips, shiny foreheads and chipmunk cheeks, and the scales have been tipped back in favour of normality - or a slightly tweaked version of it.

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