Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. It’s not due to the usual causes related to a home packed of loud adolescent children, but since it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I look,’” states the thirty-year-old real estate agent from south Florida.
Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via online call from her house. “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 plastic surgeons, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the industry edict 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 focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”
Explaining the Rhytidectomy Surgery
A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and drags the skin down with it.”
You risk operating on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow
Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and leads to laxity in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Statistics show an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients 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 optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star 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 facial ligaments beneath it, allowing doctors to reshape the face by moving the underlying layers, and preventing the tight, stretched look occasionally caused by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes 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” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”
Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the area is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use injectables in a patient because of the dangers they present. “A lot of surgeons avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after expressing worries.
Choice and Surgery
For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.
Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in the country, she decided to add a lip lift. “Then he stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|
