Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual reasons related to a house full of clamorous preteen kids, but since it’s the initial occasion she will showcase her new face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old real estate agent from Southern Florida.
How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”
Growing Trend of Early Facelifts
Based on plastic surgeons, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”
Explaining the Rhytidectomy Surgery
A facelift, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the SMAS. 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 pulls the skin downward with it.”
You risk performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue
Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the skin – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.
“Patients are now requesting to look like the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.
Advanced Lifting Method
While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Lifting the whole facial structure as a unified block results in a authentic-appearing and more durable result. It also means that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” notes Grover.
Personal Journey
Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”
If dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the reality that in a sense, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “A lot of doctors avoid discussing this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with court orders after raising their concerns.
Choice and Surgery
For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could 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 the city, sent to her by the clinic assistant at her surgeon’s office.
Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|
