Onemanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the typical reasons related to a home packed of loud adolescent children, but because it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old property agent from south Florida.
Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”
Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor 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 lifestyle choice.”
A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and pulls the dermis downward with it.”
You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow
Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now conducted for individuals aged 35-55.
“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.
While a conventional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting 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 dermis follows along as a secondary element.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and more durable outcome. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.
Preisinger had not intended on getting a facial lift – at minimum 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 reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”
If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to remove bodily fluid has been reduced.” Though research into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they present. “A lot of surgeons avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after expressing worries.
For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.
Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|
Elena Hartwell is a multidisciplinary artist and educator passionate about fostering creative communities in London.