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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a house full of clamorous preteen kids, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and preternaturally lifted, 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 cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and drags the dermis down with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes looseness in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of younger facelift patients 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 best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves elevating the SMAS, the comprehensive lift releases the underlying structures underneath, allowing doctors to restructure the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It additionally implies that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use fillers in a patient because of the risks they present. “A lot of doctors avoid discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons 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 replenishing it – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, including a three-day|