Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons associated with a home packed of clamorous adolescent children, but since it’s the first time she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.
How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates puffy 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 attacked me.’”
Increasing Popularity of Youthful Facial Lifts
According to plastic surgeons, Preisinger is among a rising count of individuals electing to have a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”
Understanding the Rhytidectomy Surgery
A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are built a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the skin down with it.”
You risk operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow
Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to looseness in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of customer towards this major operation. Statistics indicate an 8% increase in facial lifts over the last year in the UK; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.
“People are asking now to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.
Advanced Lifting Method
Where a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “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 no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.
Personal Journey
Preisinger had never planned on getting a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at right now.”
Whether dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and additional studies announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “Many doctors avoid discussing this, because the companies who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.
Decision and Procedure
For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.
Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|
