Onemanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes associated with a house full of loud adolescent children, but since it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old property agent from south Florida.
How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”
Growing Trend of Early Facelifts
According to plastic surgeons, Preisinger is among a growing number of people electing to have a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”
Understanding the Facelift Procedure
A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”
You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow
Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics show an 8% increase in facelifts over the last year in the UK; while a study found that the portion of younger facelift patients is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.
“People are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
While a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” notes Grover.
Individual Experience
Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”
Whether injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Though studies into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they present. “Many surgeons avoid talk about this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing court orders after raising their concerns.
Decision and Procedure
For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.
Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|
