Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes related to a house full of loud adolescent children, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.
How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”
Increasing Popularity of Early Facelifts
According to plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London 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 bit concerned when I see people choosing it as a lifestyle choice.”
Understanding the Rhytidectomy Surgery
A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called 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 drags the dermis downward with it.”
You risk performing surgery on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to follow
Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and causes looseness in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a new kind of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.
“People are now requesting to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the underlying structures underneath, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, 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 skin comes with it as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.
Personal Journey
Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”
If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Although studies into the topic is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.
Decision and Procedure
For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift could be what she needed to exit the cycle of treatments. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.
Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|
