Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical causes associated with a house full of clamorous adolescent kids, but because it’s the first time she will showcase her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.
Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”
Increasing Popularity of Early Facelifts
Based on cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds asking for facelifts,” says based in London 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 somewhat worried when I see people choosing it as a lifestyle choice.”
Understanding the Rhytidectomy Surgery
A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are built a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the dermis downward with it.”
You endanger operating on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue
Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.
“Patients are now requesting to look like the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.
Advanced Lifting Method
Where a conventional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Lifting the whole facial structure as a single unit results in a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer 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 reason,” says Grover.
Personal Journey
Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the filler 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 right now.”
If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been diminished.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they pose. “Many surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing legal actions after raising their concerns.
Choice and Surgery
For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.
Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|
