Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. It’s not due to the usual causes associated with a home packed of loud adolescent kids, but because it’s the first time she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.
Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse 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 needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”
Increasing Popularity of Early Facelifts
According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a facelift in their twenties and thirties – significantly before a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”
Explaining the Rhytidectomy Surgery
A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are structured a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum 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 ages us; that is what becomes lax and pulls the skin downward with it.”
You risk operating on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow
Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.
“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
While a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the underlying structures underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, 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 adjusted. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.
Individual Experience
Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But long-term using injectable gels 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 wanted to look young,” she says. “I did it because the injectable ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”
Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they move 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 slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the risks they pose. “A lot of doctors don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.
Choice and Surgery
For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida 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 selection of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.
Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe 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, including a three-day|
