Onemanda Preisinger is nervous about her child’s impending 13th birthday celebration. It’s not due to the usual reasons related to a home packed of loud preteen kids, but since it’s the first time she will reveal her new face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.
Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That indicates 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 hurting. I just look like someone jumped me.’”
According to plastic surgeons, Preisinger is among a rising count of people electing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” 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 bit concerned when I see people choosing it as a lifestyle choice.”
A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”
You endanger operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue
Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.
“Patients are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.
While a more traditional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable 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 describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.
Preisinger had never planned on undergoing 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” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”
If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Though research into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies announced. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.
For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift could be what she required to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.
Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|
A travel enthusiast and writer based in London, sharing cultural insights and personal adventures from across the UK and beyond.
