Onemanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the typical causes related to a home packed of loud preteen kids, but because it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from Southern Florida.
Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”
Increasing Popularity of Youthful Facial Lifts
According to plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”
Understanding the Rhytidectomy Surgery
A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and drags the skin downward with it.”
You risk performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow
Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the last year in the United Kingdom; while a study revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.
“People are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.
Advanced Lifting Method
Where a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.
Individual Experience
Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”
If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the reality that to some extent, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been reduced.” Although research into the topic is early-stage, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would never use injectables in a patient because of the risks they present. “A lot of doctors don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after raising their concerns.
Decision and Procedure
For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.
Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|