‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the usual reasons associated with a house full of loud preteen kids, but because it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they arrive, ‘For your information, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the result of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, 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 indicates puffy I was,” she tells me via online 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.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a facelift in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what ages us; that is what becomes lax and drags the dermis downward with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the dermis 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 comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face gets somewhat waterlogged because its ability to remove bodily fluid has been diminished.” Although studies into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been released, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would never use injectables in a client because of the risks they pose. “Many surgeons don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing 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 different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|