Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons associated with a home packed of loud preteen children, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.
Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though secured 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, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via online 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.’”
Growing Trend of Early Facelifts
Based on plastic surgeons, Preisinger is among a rising count of people electing to have a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facelifts,” states based in London 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 see individuals choosing it as a personal preference.”
Explaining the Rhytidectomy Surgery
A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” explains Kent-based 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 soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the dermis down with it.”
You endanger performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue
Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the UK; while a survey revealed that the portion of younger facelift patients 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 techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
Where a more traditional rhytidectomy entails elevating the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.
Personal Journey
Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”
Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “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 call ‘pillow face’ is additionally the fact that in a sense, the face gets somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Although research into the area is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a patient because of the risks they pose. “A lot of surgeons avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.
Choice and Surgery
For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.
Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended 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 neck lift. The eve of her operation, one day after she’d touched down solo in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|
