Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual reasons associated with a house full of clamorous preteen children, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.
Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”
Increasing Popularity of Early Facelifts
According to cosmetic specialists, Preisinger is one of a growing number of individuals electing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” 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 see individuals choosing it as a lifestyle choice.”
Explaining the Facelift Procedure
A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the dermis downward with it.”
You risk performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue
Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes looseness in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a different type of patient 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 portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.
“People are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
While a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to restructure the face by moving the underlying layers, and preventing the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.
Personal Journey
Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”
If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to remove bodily fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they pose. “Many doctors avoid discussing this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.
Choice and Surgery
For Preisinger, after beginning using injectables, she believed she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.
Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|
