Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. It’s not due to the typical causes related to a home packed of loud preteen kids, but because it’s the first time she will reveal her new face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old property agent from south Florida.
Her appearance is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”
Growing Trend of Youthful Facial Lifts
Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to have a facelift in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”
Understanding the Facelift Procedure
A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”
You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue
Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the UK; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged 35-55.
“People are asking now to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.
Deep Plane Technique
Where a more traditional rhytidectomy involves lifting the superficial layer, the comprehensive lift releases the facial ligaments beneath it, enabling surgeons to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” notes Grover.
Individual Experience
Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”
If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Though studies into the area is early-stage, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would never use injectables in a client because of the risks they present. “Many surgeons avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.
Decision and Procedure
For Preisinger, after beginning using injectables, she believed she needed to continue adding more – 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 face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.
Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|
