‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual causes associated with a house full of loud adolescent kids, but since it’s the initial occasion she will reveal her new face to friends and extended family. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her home. “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 plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, famous-figure-promoted surgical techniques are attracting a different type of customer towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a study revealed that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street 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 whole facial structure as a unified block allows for a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they present. “Many surgeons avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, 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 nearby cosmetic doctor in the state proposed that a face and neck lift might be what she required to exit the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|