My "how the fuck does she even do it" pick is Barbara Crampton
It's not even cherry picking, I invite you to scrutinize her in Google Images, at her worst lit, most candid 4k definition moments sometimes her neck wrinkles are a little too visible or the whites of her eyes are too bloodshot, and in any professionally shot footage she looks immaculate

She's pushing 70 and she's identifiably the same person she was in all of her classic horror skank roles forty years ago
Here she is pulling the rare Reverse Tom Cruise on beloved Reanimator costar Jeffrey Combs

I guess it's plausible that we all know what bad plastic surgery looks like but this is what good plastic surgery actually looks like