Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical causes related to a house full 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 come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from south Florida.
How she looks is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the initial time because I wasn’t able to even open 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 fine, I’m not in pain. I just appear as if someone attacked me.’”
Increasing Popularity of Early Facelifts
Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a facelift in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”
Understanding the Facelift Procedure
A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis down with it.”
You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue
Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.
“Patients are now requesting to appear as the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.
Advanced Lifting Method
Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.
Personal Journey
Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation currently.”
Whether dermal fillers completely disappear 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. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “A lot of surgeons avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after expressing worries.
Choice and Surgery
For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a face and neck lift might be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.
Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|
