Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a house full of clamorous preteen children, but because it’s the first time she will showcase her new face to friends and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.
How she looks is, well, a little startling – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the first time because I couldn’t 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.’”
Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”
A rhytidectomy, also known as a facelift, lifts the tissues in the face that start to sag as we age. “Our faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the dermis downward with it.”
You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow
Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to looseness in the skin – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Reports show an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.
“People are now requesting to appear as the best version of themselves and obviously the techniques are following,” comments 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.
While a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift releases the underlying structures underneath, allowing doctors to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “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 results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” says Grover.
Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”
Whether injectable substances completely disappear has long been a debated topic in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been reduced.” Although studies into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a patient because of the dangers they present. “Many surgeons avoid talk about this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.
For Preisinger, once she started using injectables, she believed she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to exit the injectable hamster wheel. After 24 months, she ended up choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.
Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d arrived alone in Turkey, she opted to include 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 contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|
Eva de Vries is a passionate book lover and local writer from Eindhoven.
