Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the usual reasons associated with a house full of clamorous preteen kids, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” states the 30-year-old real estate agent from Southern Florida.
Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”
Growing Trend of Youthful Facial Lifts
Based on plastic surgeons, Preisinger is one of a rising count of people electing to have a facelift in their 20s and 30s – significantly before a ten years prior to most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a personal preference.”
Understanding the Facelift Procedure
A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human faces are built a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, 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’s what causes aging; that is what loosens and sags and drags the dermis down with it.”
You risk operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow
Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.
“People are asking now to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.
Advanced Lifting Method
While a conventional facelift involves lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” 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 undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”
Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a client because of the dangers they present. “A lot of doctors avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” 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 felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.
Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d touched down alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|
