Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the usual reasons associated with a home packed of clamorous adolescent children, but because it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” states the thirty-year-old real estate agent from south Florida.
Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”
Growing Trend of Youthful Facial Lifts
According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”
Explaining the Facelift Procedure
A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and pulls the dermis downward with it.”
You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue
Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the widespread use of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.
“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
While a more traditional facelift involves lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.
Personal Journey
Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”
If dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the reality that in a sense, the face gets somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research initiated. 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 present. “A lot of doctors don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.
Choice and Surgery
For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.
Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek 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|
