‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual reasons associated with a home packed of clamorous preteen kids, but because it’s the initial occasion she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer 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 is what becomes lax and drags the skin down with it.”

You risk operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of customer towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

Whether injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they pose. “Many surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor 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 found herself choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|