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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual reasons associated with a house full of clamorous adolescent children, but since it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the skin down 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 excessive use of injectable gels stretches the face and causes looseness in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Although research into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies initiated. One highly regarded face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they present. “Many doctors avoid talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a selection of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor 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 eve of her operation, 24 hours post she’d touched down solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|