Sixty isn’t the new 40. “That’s an outright lie,” Dr. Lynn said. “What is true is 60 is the new 60.”

Admitting that appearance matters can be painful for women who feel “slightly insulted by the fact,” Dr. Diller said. Wasn’t feminism supposed to make promotions and ceiling-shattering the attention getters, not a taut brow?

The book’s most intriguing stories come from patients who are surprised to find themselves mourning their sags and veiny legs. Katherine, who did not use her real name in the book, is a 53-year-old science researcher and mother of three who considered herself in the “More Important Things to Worry About” camp. But when she nixed a beach getaway with her husband because she didn’t feel comfortable in any swimsuit, she was troubled by how much she cared. Belatedly, she came to recognize that her family may have taught her that caring about appearance is superficial, but that she could be a woman of substance who happened to use a retinoid at night or visit a spa on occasion.

Image UP FRONT Dr. Vivian Diller, left, and Dr. Jill Muir-Sukenick are trying to help women better accept themselves and the aging process. Credit... Joshua Bright for The New York Times

This can-do age of aesthetics is particularly stressful because the playing field is no longer equal. A baby boomer is pressured to choose whether her brow will be au naturel or smooth during her later years — a decision her mother did not face. Ann Kearney-Cooke, 54, an expert in body image in Cincinnati, said the message those grandmothers heard as their looks went was insulting: “You’re not going to be pumping out babies anymore — you’re not as much use to society.” But at the very least, the sight of peers with just as many wrinkles was a comfort. They could think we are “all in the same boat,” said Dr. Kearney-Cooke, a psychologist.

The authors of “Face It” point out that today an odd morality creeps into our calculations of what we find acceptable. Ridiculing too-obvious cosmetic surgery is now a great American pastime. A post on Gawker asking why people still get plastic surgery recently garnered more than 400 comments, many sent by e-mail from high soapboxes.