Onemanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical causes related to a home packed of loud adolescent kids, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” states the 30-year-old real estate agent from Southern Florida.
How she looks 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, temporary – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed 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 home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”
Increasing Popularity of Early Facelifts
According to plastic surgeons, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”
Understanding the Facelift Procedure
A rhytidectomy, also known as a facelift, elevates the tissues in the face that begin to droop as we grow older. “Human faces are built a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the skin downward with it.”
You risk performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow
Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the skin – combined with the widespread use of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are attracting a new kind of patient towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.
“Patients are now requesting to appear as the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.
Advanced Lifting Method
Where a conventional rhytidectomy involves lifting the superficial layer, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit 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 youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.
Personal Journey
Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be in this situation right now.”
Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been diminished.” Although research into the area is early-stage, warnings on injectables’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they present. “A lot of doctors avoid talk about this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.
Choice and Surgery
For Preisinger, after beginning using injectables, she felt as if she needed to continue adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.
Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|
