Honestly, I am dead in the morning. If I have seven hours’ sleep I’m fine, but usually I’m a bit short. Monday night I’m on Eurostar, and on Tuesday I wake up in my little house in Chelsea. I can’t eat. I just have black coffee before my yoga teacher arrives at seven. She’s a girl, of course — I don’t deal with men! All my staff are women. Apart from a few patients, I don’t have men in my life. They’re unreliable and I don’t like the ego thing — I can’t work with them.

I shower twice a day, minimum, and I wash my hair every time. I shave and pour my own Serum Repair, mixed with vitamin-C powder, onto my face. I used to wear a suit all the time, but I’ve decided to be free, and now I even wear jeans to work. It’s a revolution.

I don’t drive in London. A cab picks me up at 8.15, then it’s BlackBerry time. My life is not so easy. I have the clinic and I have my products and I’m a control freak — I want to know about everything. My BlackBerry has helped; I can see what’s going on and I don’t interfere so much, but I can be very bad-tempered. I try to be calm and then — poof! — I explode. But I am the boss, d’accord?

Even when I’m not really happy in my private life, work is my pleasure. I love my patients. They are everybody from royals to celebrities to the sweetest teacher from the north of England to a granny of 80. I select my patients and they stay with me for years. Obsessional types are not for me. I work 12 hours a day and I want to work with people I like. It’s all important, from the face to the way she talks, her manners, the smell. I’m allergic to strong perfume. If I don’t like a person — and I don’t care who they are — I’ll say: “I’m sorry, I can’t do anything for you.”

My patients come three or four times a year for maintenance. We don’t argue about what I’m going to do: it’s a long-term relationship based on trust. Sometimes it’s very little. Then you age suddenly and it’s time to do more. I have the worst memory for names, the best memory for faces. I can tell if a patient has changed her hair colour or make-up. As well as Botox, I use fillers and vitamin injections. Some women have a filled, Botoxed look: big, plumpy cheeks and lips that are horrible and out of proportion, but with skill everything can be harmonious. I have patients in their sixties who are the perfect combination of maturity, beauty, life and soul.

I was a plastic surgeon for more than 20 years. Face, body and lipo. I don’t like breasts so much. Women change their minds all the time about their breasts — more, less, new boyfriend, more. If you want to change your face, don’t come to me. I use aesthetic procedures to slow down the ageing process. I’m like a picture restorer. I don’t want to change the painting, I want to keep your face in good nick for as long as possible by giving back what you’re losing. I can’t give you back the face you had at 25, but if you come to me two or three times a year at 35 or 40, I can keep your face that way for 20 years without surgery.

I’m Virgo with Virgo rising: the tray, the bottles, they all have to be in the same place. Order and routine make me feel safe. I’m sugar-sensitive — it sends my mood all over the place — so lunch is always rice, and I eat it standing up in the kitchen. Ten minutes, no more. I see maybe 25 or 30 patients in a day. We gossip, we laugh, and if they’re having a bad time, they cry. Sometimes they’re broke and we don’t charge them. I can be with a patient for 10 minutes or an hour and a half. I never know — which is why I’m famous for being late.

I started using Botox on myself at 39 and I have very few wrinkles. What I love most is the Fraxel machine. Radio waves penetrate the dermis and stimulate the collagen. I call it the dry cleaner. I feel tired, I have a session, I feel neat again.

I leave at 7.30-8pm and go straight to a restaurant. At night, always fish. And vodka with lime and soda. I used to go out with a very famous, social woman; she would pick me up and take me to parties. I liked it, but it was tricky. People you’ve treated in the day don’t want to see their doctor out at night. I’m a little asocial now. My new girlfriend is not a socialite and I’m back to my old habits. I like tête-à-tête but I need my quiet time.

I’m taking better care of myself these days. I have a personal trainer and I see a cranio-sacral osteopath, which helps my energy. If I don’t do this I get so tired I can’t make it. Two years ago I felt finished. Bad diet, stress, my divorce… it almost killed me. You need to be happy to be well, and for me the whole stupid dream was broken. Since my divorce I don’t care about possessions. I have two sweet teenagers and money is freedom to raise them how I want — nothing else.

I’m not into very young women. My girlfriend is 44 and she is lovely. The prerequisite for great sex isn’t beauty, or youth — it’s self-esteem. I go to bed around midnight — always naked — and I have a wonderful deep sleep. I’m comfortable with loneliness, but I love to be in bed with someone, especially if they scratch my back till I go to sleep.

Interview: Caroline Scott. Photograph: Leo Maguire

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