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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the usual causes associated with a home packed of loud preteen children, but because it’s the first time she will debut 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 look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years before typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Statistics show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes 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 getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is also the reality that to some extent, the face becomes slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they pose. “A lot of doctors avoid talk about this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – 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 facial and neck surgery might be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|