‘I Couldn’t Even Open My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the usual reasons associated with a house full of clamorous adolescent kids, but because it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the ligaments in the face that start to sag as we grow older. “Human faces are built a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and drags the dermis downward with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of customer towards this major operation. Statistics indicate an 8% increase in facial lifts over the last year in the UK; while a survey found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and obviously the techniques are evolving,” comments 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 entails elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, allowing surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the filler ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its capacity to remove bodily fluid has been diminished.” Though research into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the risks they pose. “A lot of surgeons avoid talk about this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some buccal 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|