Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. It’s not due to the usual reasons associated with a house full of clamorous preteen kids, but since it’s the first time she will debut her new face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I look,’” says the thirty-year-old property agent from south Florida.
How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”
Based on plastic surgeons, Preisinger is among a growing number of people choosing to have a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor 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 personal preference.”
A facelift, also known as a facelift, lifts the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis down with it.”
You risk operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow
Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.
“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.
While a conventional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains 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 passenger.” Lifting the whole facial structure as a unified block results in a authentic-appearing and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.
Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”
If dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would never use fillers in a patient because of the risks they present. “Many doctors don’t want to talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing court orders after raising their concerns.
For Preisinger, after beginning using injectables, she believed she needed to continue adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. Two years later, she found herself selecting from a list of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.
Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|
Maya Chen is a freelance writer and urban enthusiast with a passion for documenting city life and cultural shifts.
