Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the typical causes related to a house full of clamorous preteen kids, but because it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I look,’” states the 30-year-old property agent from south Florida.
How she looks is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse 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 tells me via online 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.’”
Increasing Popularity of Early Facelifts
Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to have a facelift in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”
Explaining the Facelift Procedure
A facelift, alternatively called a rhytidectomy, elevates 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 stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and drags the dermis downward with it.”
You risk performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue
Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to looseness in the skin – combined with the widespread use 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. Statistics show an 8% increase in facial lifts over the last year in the UK; while a survey found that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged 35-55.
“People are asking now to look like the best version 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 Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.
Deep Plane Technique
While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.
Personal Journey
Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”
Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face gets somewhat fluid-filled because its ability to drain bodily fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, says he would never use fillers in a client because of the dangers they present. “Many surgeons avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with court orders after expressing worries.
Choice and Surgery
For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift could be what she needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.
Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|
