Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the typical reasons related to a home packed of loud preteen kids, but since it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.
Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”
Increasing Popularity of Early Facelifts
Based on cosmetic specialists, Preisinger is among a rising count of people choosing to have a facelift in their twenties and thirties – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”
Understanding the Facelift Procedure
A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are built a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the dermis down with it.”
You risk performing surgery on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue
Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and causes looseness in the skin – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged 35-55.
“People are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
While a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the facial ligaments underneath, enabling surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” explains 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 secondary element.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.
Personal Journey
Preisinger had not intended on getting a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”
Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets somewhat waterlogged because its ability to remove bodily fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the risks they pose. “A lot of doctors avoid talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after expressing worries.
Choice and Surgery
For Preisinger, after beginning using injectables, she believed she had to keep adding more – 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 facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.
Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|
