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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons associated with a house full of clamorous preteen kids, but because it’s the first time she will debut her new face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we grow older. “Human faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the skin – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed operative methods are attracting a new kind of customer towards this major operation. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the underlying structures underneath, enabling doctors to restructure the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the whole facial structure as a unified block results in a authentic-appearing and more durable outcome. It additionally implies 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 contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly waterlogged because its capacity to remove bodily fluid has been reduced.” Though studies into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a client because of the dangers they present. “Many doctors don’t want to discussing this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift could be what she needed to finally step off the cycle of treatments. Two years later, she found herself selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|