‘I Couldn’t Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a home packed of clamorous adolescent kids, but since it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

How she looks is, well, a somewhat startling – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I observe individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the skin down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the development of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable result. It also means that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using fillers in a client because of the dangers they present. “A lot of surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – particularly when it started to migrate to other parts 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 required to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option 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 touched down alone in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|