Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the usual reasons associated with a house full of loud preteen kids, but because it’s the first time she will debut her new face to friends and extended family. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” says the thirty-year-old property agent from Southern Florida.
Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”
Increasing Popularity of Youthful Facial Lifts
According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”
Explaining the Facelift Procedure
A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the dermis down with it.”
You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow
Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Reports show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.
“People are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.
Deep Plane Technique
Where a conventional facelift involves lifting the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking 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 “enhancement” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.
Personal Journey
Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”
If injectable substances completely disappear has long been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the fact that to some extent, the face becomes slightly fluid-filled because its ability to drain bodily fluid has been reduced.” Though studies into the area is early-stage, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the dangers they present. “A lot of surgeons don’t want to talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.
Choice and Surgery
For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift could be what she required to exit the injectable hamster wheel. After 24 months, she ended up choosing between a list of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.
Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d touched down solo in the country, she decided to add a lip lift. “Then he stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|
