Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of loud adolescent children, but since it’s the initial occasion she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.
Her appearance is, admittedly, 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 – look is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”
Increasing Popularity of Early Facelifts
Based on plastic surgeons, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”
Understanding the Facelift Procedure
A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls 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 excessive use of injectable gels stretches the face and causes looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.
“Patients are asking now to look like the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” 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 secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.
Individual Experience
Preisinger had not intended on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied 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 did it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”
If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face gets slightly waterlogged because its capacity to remove bodily fluid has been diminished.” Though research into the area is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the dangers they pose. “Many doctors don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.
Choice and Surgery
For Preisinger, once she started using injectables, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.
Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘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 adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|
