Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of loud adolescent kids, but because it’s the initial occasion she will showcase her new face to friends and relatives. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not how I appear,’” states the 30-year-old real estate agent from Southern Florida.
How she looks is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”
Increasing Popularity of Early Facelifts
Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a facelift in their twenties and thirties – well over a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”
Understanding the Facelift Procedure
A rhytidectomy, also known as a facelift, elevates the tissues in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis downward with it.”
You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to pursue
Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged 35-55.
“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.
Deep Plane Technique
While a more traditional facelift entails elevating the superficial layer, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to reshape the face by moving the underlying layers, and preventing the tight, stretched 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 cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.
Personal Journey
Preisinger had not intended on getting 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 desired to appear young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”
Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they present. “Many doctors avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing court orders after expressing worries.
Choice and Surgery
For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – especially as it started to migrate 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 required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.
Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her operation, one day after she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|
