Sacre bleu-tox! Amid rumours of an affair with a young lover, has Carla Bruni had a little help keeping up appearances?

By Jenny Stocks for MailOnline
Updated: 04:18 EDT, 17 March 2010

She was once lauded as one of the world's most beautiful women. Before becoming the First Lady of France, her dazzling good looks had captured the hearts of Mick Jagger and Eric Clapton.

But, it seems, age and lifestyle  -  not to mention those infidelity rumours  -  have taken their toll on Carla Bruni.

An unflattering close-up shot this week has revealed how the once radiant former model's face is looking tight and stretched, while her skin appears dull and lifeless.

To get to the bottom of 42-year-old Carla's curious look, JENNY STOCKS asked beauty experts to give us their opinions on how she is ageing and what she may be doing to combat the passing of the years..

Feeling the strain? Age and lifestyle appear to have taken their toll on Carla Bruni's face

SURGERY

Dr Alex Karidis, London cosmetic surgeon

Carla is showing all the classic signs that suggest a devotion to Botox and fillers. Her forehead is quite smooth, and if you drew a vertical line through the centre of each eye, more eyelid is showing on the outer halves.

This is because Botox freezes the middle of the forehead but still allows the use of the frontalis muscle that raises the eyebrows, which is why they appear to slant upwards at an angle. As Carla has always had quite almond-shaped eyes, this has the effect of making her look almost feline.

The tiny shadows you can just see beneath her nose were probably caused by injectable fillers to get rid of nose-to-mouth lines.

Fresh-faced: Carla as she looked in 1995

And although she had plump cheeks in her youth, it looks like they have been injected with filler, too, as they are very defined. It would most likely be hyaluronic acid, a water-and sugar-based gel that acts as Polyfilla inside the skin to prop it up and give volume.

Unfortunately as we get older, our facial volume decreases as the fat below the skin thins out unless we put on weight, which Carla is unlikely to want to do. Her high cheekbones mean that only a small amount would give this dramatic effect.

The lips thin as we get older, yet her top lip looks fuller than it did in her 20s, so she has almost certainly had some filler here, too, to plump it up and give it shape. Again, this is likely to be hyaluronic acid, such as the popular brand Restylane. It only lasts for four or five months, but is less likely to cause an allergic reaction than collagen.

While her nose has looked the same for years, the slight asymmetry  -  her nostrils are different shapes  -  and the shape of the tip leads me to think she had surgery (rhinoplasty) on it when she first started as a model in her teens.

SKIN

Dr Dav Panacer, medical director of skinmedics.co.uk

The change in Carla's skin tone just in the past year is dramatic  -  it would be easy to think this was another person if you compared it to her glowing skin during the G8 summit. It looks to me like the ageing process has been accelerated, which can be caused by factors such as sun damage, smoking, alcohol and stress.

Photo-damage from sunlight is the most common cause of premature ageing. As she has quite pale skin, Carla is more susceptible to skin damage.

The skin under her eyes is thin and wrinkled, which happens when the collagen and elastin in the skin's cells breaks down. This can happen faster in the delicate skin below the eyes.

Tres chic: Turning heads with French president Nicolas Sarkozy at the Bastille Day military parade in Paris, July 2008

What might have also sped up this effect is the filler that has likely been injected into her cheeks  -  sometimes as it lifts the cheeks, it also pushes up the skin beneath the eyes and makes it appear more wrinkled.

She appears to have lots of open pores on her cheeks and chin, which again is part of the ageing process.

She looks like she uses a lot of make-up to cover them, but this can actually make the problem worse because it can block the sebaceous glands and make the pores become more obvious.

DIET

Still glowing: Carla in Pennsylvania in September during the G20 summit

Sian Porter, consultant dietician and spokesperson for the British Dietetic Association

If Carla had a poor diet in the past, it might have only just caught up with her now she's in her 40s. Many models survive on a diet of cigarettes, black coffee and an occasional yoghurt, which clearly has little benefit to health. She was a singer, too, so has likely spent late nights in smoke-filled clubs, which again doesn't bode well for her skin.

Now she is wife to a world leader, and the recent affair rumours will have only added to the stress. Stress can have an enormous physical effect on the condition of the skin, especially as it is also linked to lack of sleep and appetite.

As a former model who remains slim, Carla needs to make sure she has enough fat in her diet, especially Omega-3 fatty acids. Lack of these essential fats can cause dry skin.

It's important to get enough vitamin C to maintain the structure of the skin  -  if she is a smoker, she needs double the amount to get the same effect. Women who limit their carbs often cut B vitamins out of their diet, which could affect skin quality. If Carla drinks alcohol, the dehydration effects would show on her skin.

MAKE-UP

Julia Bolino, make-up artist and owner of slap.uk.com

It is shocking to see Carla looking like this. It looks like she's been caught out in the harsh light. She's wearing make-up on her face and eyes, but her skin looks in very bad condition, quite lumpy.

She has small eyes, but she could make much more of them with makeup. She also appears to have very few eyelashes. As women get older, wear and tear means that they can lose eyelashes, but Carla could use semi-permanent eyelash extensions to make them appear fuller.

Botox seems to have accentuated her already almond-shaped eyes, so she needs to do all she can to open them up.

She looks much paler than she did when she was younger, which has left her pasty and washed out.

Her very weak lip line is also ageing. If she used a nude liner to fill in the edge of her lips, it would make the line much stronger.

Youthful: Carla performs in Paris in November 2003