Plastic fantastic: is surgery transforming some of Hollywood's best-known and best-loved faces?

And this in a town which has long considered womens physiognomy a pretty moveable feast.

Yet theyre not alone. Look past Renee and Uma, and theres Courtney Cox, who seems to have acquired a more exaggerated and wider cheek bone.

Heres Catherine Zeta Jones, who looks side on as though someone has popped a spare breast implant under each cheek. Scarlett Johansson, at a youthful 30, has even laid down a marker, saying: ''I definitely believe in plastic surgery. I dont want to be an old hag. Theres no fun in that.

Crucially it doesnt seem enough to look ''refreshed, any more. Practitioners of the new approach seem to be adopting a design ethic that knows no aesthetic limits.

Uma Thurman in Sweden three months ago (Rex)

So whats driving it? One Hollywood insider tells me that women are on a desperate trajectory: ''Two things are forever on the rise out here: cosmetic science and female insecurity. Merge the two and you get the perfect storm were now witnessing, where stars seem to want to look like anyone but themselves - and are succeeding. The casting couch long ago went the way of multi-million dollar lawsuits, but in its place is a far more insidious thing: female actresses are being urged - either directly or covertly - to compete with younger women in the looks stakes, or they will be replaced, she says.

''Cue the rather desperate measures we are bearing witness to. Out here your looks, after all, are your fortune. And in this age of HD TV, women will do whatever it takes to stay in the game.

Shes echoing the words of fiftysomething Kim Cattrall (the sexually voracious Samantha in Sex and the City), who has pointed out: ''You have to be desirable. And thats why so many woman of my age or even younger are pushed to Botox and plastic surgery, all the things that people ask 'Why do women do this? But where do you go in your fifties in your career?

Before and after: Rene Zellweger (REUTERS)

Certainly, Tinseltown is no stranger to visage-shifting stars. One of the first was Carole Lombard who, in 1926, had surgery to reduce the appearance of a facial scar. In 1958, medical records show that Marilyn Monroe consulted a doctor about her 'chin deformity, work that was apparently confirmed by the release this week of photographs taken of Monroe during one of her first shoots in 1946, which show a cheery-faced adolescent, with a well-rounded jawline instead of the more familiar heart-shape of legend.

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Plastic fantastic: is surgery transforming some of Hollywood's best-known and best-loved faces?