Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. It’s not due to the usual reasons related to a home packed of clamorous adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from Southern Florida.
How she looks is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”
Increasing Popularity of Early Facelifts
Based on cosmetic specialists, Preisinger is among a rising count of individuals electing to have a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”
Understanding the Rhytidectomy Surgery
A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework 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 deeper issues. It’s not a practice for an ethical plastic surgeon to follow
Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and leads to laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.
“Patients are now requesting to appear as the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.
Deep Plane Technique
Where a more traditional facelift involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled look sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.
Personal Journey
Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”
If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Although research into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using fillers in a patient because of the risks they present. “Many surgeons don’t want to talk about this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.
Choice and Surgery
For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.
Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|
