Susan Dell has prompted fresh online speculation about Botox, Dysport and cosmetic surgery after appearing at the White House with her husband, Michael Dell, and President Donald Trump. Her face appeared tighter and her eyes more open to some viewers.

There is no public confirmation that Dell, 62, has had any cosmetic procedure. Doctors stressed that any assessment remains speculative without a consultation, and none of the surgeons quoted here has examined her.

The couple appeared on 7 October at a White House event marking the expansion of Trump Accounts, which provide eligible children with a $1,000 (£757) government seed contribution. The Dells have pledged $6.25 billion (£4.73 billion) to provide an additional $250 (£188.90) to the first 25 million eligible children, but Susan Dell's appearance also drew substantial attention online.

What Is 'Mar-a-Lago Face'?

The look has been dubbed 'Mar-a-Lago face'. Dr Samer Jaber, a New York City dermatologist, described it as full lips, high cheekbones, bright white teeth, a strong jawline and minimal facial movement with well-defined eyebrows.

Dr Troy Pittman, a plastic surgeon based in Washington, DC, said the look can involve generous amounts of filler along with Botox and Dysport. Dr Kelly Bolden, a Washington, DC, plastic surgeon, said excessive filler and Botox can create a 'mask-face' appearance.

Dr Shervin Naderi, a facial plastic surgeon and founder of The Naderi Center, called it 'a modern aristocratic mask'. He wrote that the look is less about reversing time than about changing how ageing is perceived.

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Doctors Weigh In on Dell

Dr Ross Perry, medical director of Cosmedics skin clinics, said her face looks tighter and tauter than in earlier photographs. He added that the area around her eyes appears more open than usual.

Perry said a full facelift was one possibility, noting that the skin around the jawline and mid-face appeared lifted. He also suggested upper blepharoplasty, or upper-eyelid surgery, as another possibility that can make the eyes appear more refreshed.

Non-surgical options could also explain the change, according to Perry. Botox can smooth forehead and frown lines, while fillers in the cheeks or tear troughs can restore lost volume and create a more youthful contour.

He cautioned that overusing injectables can backfire. Too much Botox around the eyes or too much filler in the mid-face can contribute to a 'wide-eyed' or startled appearance.

Overfilling and Perception Blindness

Dr Gerard Lambe, a cosmetic surgeon and founder of the Reflect Clinic, said that, from public images alone, Dell may have had facial rejuvenation work. He listed fillers, fat transfer, eyelid surgery, a facelift and lip augmentation as possibilities.

Lambe said that, if filler had been used, overfilling could potentially account for some of the apparent changes. This can create a 'pillow face' appearance in which natural contours become less defined, with excessive fullness and, in some cases, filler migration.

Lambe estimated that any such work could cost $50,000 (£37,848) to $100,000 (£75,697) or higher over time. Perry put a full facelift at up to $40,000 (£30,279).

Bolden described a phenomenon she sees in some patients as 'perception blindness'. A first round of filler may look good, but patients can become accustomed to the change, notice a wrinkle returning and ask for more without recognising how their appearance has gradually evolved.

Bolden said cosmetic results are not necessarily permanent. Dermal fillers are generally temporary, while the effects of a facelift can last for several years, although ageing continues and some patients may eventually consider further treatment.

Dr Jennifer Newman Keagle, a plastic surgeon in Los Angeles, said her clinic aims for a natural 'me but better' look. She said a 60-year-old woman should not have the same face as a teenager.

Keagle said she never wants a patient to look noticeably altered. She and Jaber both expect a return to subtler, more natural-looking procedures.

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