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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the usual reasons associated with a house full of clamorous preteen children, but since it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “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 grow older. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis down with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Statistics show 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 one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an effort at “facial balancing” meant that by the time she reached 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 harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they pose. “Many surgeons avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, 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 laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived solo in Turkey, 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 remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|