Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a house full of clamorous adolescent children, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.
How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”
According to plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a facelift in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”
A facelift, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and drags the skin downward with it.”
You endanger performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow
Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes laxity in the skin – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is growing, with one-third of procedures now performed on patients aged 35-55.
“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 figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.
Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling doctors to reshape the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” says Grover.
Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”
Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its capacity to drain bodily fluid has been reduced.” Though research into the topic is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a client because of the risks they present. “A lot of doctors don’t want to talk about this, because the companies who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.
For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.
Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|
