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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a house full of loud adolescent children, but because it’s the first time she will reveal her new face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed 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 wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people electing to have a rhytidectomy in their twenties and thirties – well over a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and drags the skin down with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of youthful candidates is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift involves lifting the superficial layer, the deep plane facelift releases the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties 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 attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would never use fillers in a client because of the dangers they pose. “Many doctors avoid discussing this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|