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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the typical reasons related to a home packed of loud preteen children, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the 30-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a facelift in their 20s and 30s – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and drags the dermis down with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves lifting the superficial layer, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients 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 injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear 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 currently.”

Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that in a sense, the face gets somewhat waterlogged because its capacity to remove bodily fluid has been reduced.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they present. “A lot of surgeons avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|