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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the usual causes associated with a home packed of loud adolescent kids, but because it’s the initial occasion she will debut her recently altered face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of individuals electing to have a facelift in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and drags the skin down with it.”

You endanger operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels stretches the face and causes looseness in the dermis – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are now requesting to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails 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 preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face gets slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Although research into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would never use fillers in a client because of the dangers they present. “A lot of doctors avoid discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift might be what she required to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d arrived alone in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will 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 recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|