Well Shakespeare may have been right about Cleopatra, but I think even he would have laid down his quill at the sight of a 65 year old woman hoping plastic surgery would give her the boobs she had 30 years ago. Yes, Channel 4 shows yet again that tax payers' money isn't required to produce the kind of attention-grabbing, jaw-dropping, crassly-titled TV programmes that the BBC doesn't dare to. 'Bus Pass Boob Job': with a title like that, how could I resist?

Channel 4 was also responsible for documentary series 'The Clinic', set in a private cosmetic surgery practice, so seeing people sliced open and stitched back together is old territory. But regardless of how often the scalpel is brandished, I'm still far too squeamish to watch the actual operations, and the sight of someone with eyes puffed up like they've gone 10 rounds with a heavy weight boxer leaves me fidgeting unhappily. Plastic surgery itself is old hat for TV viewers, but this one came with a twist: it wasn't some misguided 17 year-old wanting to be a glamour model that was begging to go under the knife, but a pensioner who couldn't admit that her youth and looks were long gone.

Three people were featured, and two of them - the 65 year old woman and a 70 year old man - were hoping for what in reality was a miracle, even in this day and age of botox, liposuction and all manner of nasty things that you can have done in the pursuit of beauty. Revealingly, both of them had had brushes with fame: the woman was an ex-amateur model, and the man had been a member of a 60s boy band. Lost opportunities, lack of attention, no more glamour - all these things were in the past with their youthful good looks, and nothing on earth could bring them back. There is always something especially poignant about people who try hard to be famous yet never quite get there, a certain amount of hopefulness and quiet desperation, along with delusion, clings to them and makes it hard to be as brutally honest as you could be. But in this case, I really think the surgeons' job was to shatter a few of those illusions, rather than pandering to them.

The final participant was a 68-year old who wanted a breast reduction, but a surgeon refused on the grounds that she was doing it for the wrong reasons. At that age I'm not sure what the right reasons would be, but he was honest and she at least had the strength of character to admit he was right. Smaller breasts would not bring back the husband who had left her 13 years ago for a younger woman, or give her back the confidence she had lost because of that. People who want plastic surgery obviously think they have good reasons for undergoing such an unpleasant and possibly dangerous operation, but whether they will really get what they want is far less predictable than the physical results of the surgery.

The documentary raised more questions than it answered. At what age should/do people stop worrying about their looks? I'd like to think that vanity and insecurity slowly diminish as wisdom and more pressing concerns set in, but now I don't think so. Surely if you've lived well and have few regrets, you can forgive the wrinkles and sagging skin? I watched those people with pity and a twinge of anxiety, knowing that at the moment I have nothing in my life to stop me worrying about getting old. Loneliness breeds dissatisfaction with yourself, and with no one to buoy you up or tell you when you're being crazy, an idea such as 'I'd love to get rid of these wrinkles' can get out of hand. Nowadays, when we are promised (and expect) so much in terms of health, wellbeing and beauty, who's to say when you are too old to be ugly? Not those surgeons who can make money from vanity, just by giving people what they (think they) want.

It wasn't age that these people were struggling to come to terms with - I'm sure no one would mind being 100 if they still had the body of a 20 year old - but looking old when so many things in our culture are aimed at young people. I'm not ageist, I just hoped that by the time I qualify for a free bus pass, I might have finally left behind my insecurities and vanities. That at least would have been something to look forward to. Now it seems that young or old, the pressure to look better, younger, more attractive, is always on. If there was a moral to take from this programme, it was start looking for the beauty within, because sooner or later you're going to need it.