Sixteen years ago this week, I was on my honeymoon in Paris when I got my first real taste of "appearance medicine".

We were having dinner at a posh restaurant, which we had booked months in advance, and as we sat in our ornate, gold-painted, velvet-upholstered booth, we realised that we were dining next to some of Paris' better-off residents.

We knew this because the women all looked about 30 years old and their husbands looked 70.

"Cosmetic surgery," I whispered to my husband. "Ghastly."

In those days facelifts were glaringly obvious. Women peered out of skin that had been pulled back to the hairline and stitched in place.

"You're right," said my husband, who can speak French. "That's what they are talking about."

We watched in awe as everyone at the table next to us felt faces, discussed the quality of the work, compared surgeons and planned the next job. There was not a hint of secrecy or any effort to try to cover up that they were trying desperately to look younger.

With typical French frankness it was just part of life.

These days Botox is the answer for many women.

Supportive wife has been thinking that perhaps it would be fitting to do something about her appearance. She realised that for the past three months she has rarely dressed in anything other than jeans and an old jumper and when forced to dress up a bit, drags the same old little black dress out of the closet.

And then there are the wrinkles. Fine lines around the eyes, little creases above the top lip and one hell of a frown line between the eyebrows.

I know many women who get "a bit of Botox" every three months. I like the way they say "a bit" as if to minimise the act. Like they're just taking a teeny weeny bit of poison.

I ask them how they feel about being injected with a known toxin and they shrug their shoulders.

"The nurse says it's perfectly safe," they say as they down another glass of wine. I pity their liver as it labours away cleansing the Botox out of their system, and then has to deal with the alcohol on top of it.

What I see are women who place vanity and the need to resist ageing before sensible thinking.

Botox is a toxin, we know this. Even the people who inject it into women accept this. On the Caci website there is a handy Q and A section that answers the question "Botox, isn't it a toxin?" with "Yes, it is a toxin, but most medicines are potential toxins." That's like saying: "Yes, a hammer is a potential murder weapon, but most tools are."

It also rather disturbingly confirms that you can get "droopy eye" from Botox injections. Very attractive.

Let's talk about things we have been told were safe in recent times. Smoking is good for you, doctors told us for years as supportive wives all over the world puffed on cancer sticks in the belief they would keep them slim, make them nicer to be around and more glamorous. Doctors featured in advertising reassuring us that smoking was good for you and babies were used in advertising too: "Before you scold me Mom, maybe you'd better light up a Marlboro."

Asbestos was known to cause lung problems and death since the 30s, yet workers were still mucking around in the stuff in the 80s, unaware that vital medical evidence was kept hidden.

Taking thalidomide is fine for morning sickness, my mother was told by her doctor, before turning it down.

Not so long ago, in the 50s, when supportive wives were in their heyday, women were encouraged to eat tapeworms to lose weight. It can only be a matter of days before a Kardashian brings that craze back.

This supportive wife has opted not to wake up in 10 years and find that her liver, having laboured away clearing Botox out of her system, has given up.

Instead, she'll accept that ageing is a natural process. She might stretch to putting a bit more effort into plucking her eyebrows and dressing in something other than jeans. Or she might not.

By Wendyl Nissen Email Wendyl