‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the typical reasons associated with a home packed of loud adolescent kids, but because it’s the initial occasion she will debut her new face to acquaintances and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of people electing to have a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we age. “Human faces are structured a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the skin downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports show an eight percent rise in facelifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves elevating the superficial layer, the deep plane facelift releases the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face gets somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded face specialist, speaking anonymously, says he would avoid using fillers in a client because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d touched down alone in Turkey, she opted to include a lip lift. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|