Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. It’s not due to the typical causes associated with a house full of loud preteen children, but because it’s the initial occasion she will debut her new face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from south Florida.
Her appearance is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how 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 in pain. I just look like someone attacked me.’”
Increasing Popularity of Early Facelifts
Based on cosmetic specialists, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”
Explaining the Rhytidectomy Surgery
A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are built a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis down with it.”
You endanger 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, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Reports show an 8% increase in facelifts over the last year in the UK; while a survey found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.
“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.
Deep Plane Technique
While a conventional facelift involves elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable 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 describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.
Individual Experience
Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”
Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would never use injectables in a client because of the dangers they pose. “A lot of surgeons avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with court orders after expressing worries.
Choice and Surgery
For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. After 24 months, she ended up 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 eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding 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 touched down alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think 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 half-day surgery, plus a three-day|
