Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous adolescent kids, but because it’s the initial occasion she will debut her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” states the 30-year-old property agent from Southern Florida.
How she looks is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”
Increasing Popularity of Youthful Facial Lifts
According to cosmetic specialists, Preisinger is one of a growing number of people electing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting 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 bit concerned when I observe individuals choosing it as a lifestyle choice.”
Understanding the Facelift Procedure
A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS 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 individuals that have deeper issues. It’s not a practice 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 causes laxity in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Reports indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.
“Patients 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 comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.
Deep Plane Technique
While a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.
Personal Journey
Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”
Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly waterlogged because its ability to remove bodily fluid has been reduced.” Though research into the area is early-stage, warnings on injectables’ potential impact on the body’s drainage have been released, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned 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 make injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.
Choice and Surgery
For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.
Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity 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 opted to include a mouth enhancement. “Then he said, ‘We will 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 surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|
