Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons associated with a home packed of clamorous adolescent kids, but since it’s the first time she will debut her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not how I appear,’” states the 30-year-old real estate agent from south Florida.
Her appearance is, well, a little startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”
Growing Trend of Early Facelifts
According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a facelift in their 20s and 30s – significantly before a ten years prior to most doctors’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based 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 people choosing it as a lifestyle choice.”
Understanding the Rhytidectomy Surgery
A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin down with it.”
You risk performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow
Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey found that the percentage of youthful candidates is increasing, 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 naturally the techniques are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.
Deep Plane Technique
While a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, 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 undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the filler harmed my face. I regret ever using it. If I had avoided the filler, I don’t think I would be in this situation right now.”
Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the reality that in a sense, the face becomes slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although studies into the topic is early-stage, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded face specialist, speaking anonymously, says he would never use fillers in a client because of the risks they present. “Many surgeons avoid talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after raising their concerns.
Choice and Surgery
For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery might 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 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 looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|
