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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. Not for the usual reasons associated with a house full of clamorous adolescent children, but since it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Explaining 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 structured a bit like layers of an onion,” 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. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the skin down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, cut-price surgical travel, and the development of new, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the underlying structures beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and preventing the tight, stretched look sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

Whether 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,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to drain bodily fluid has been diminished.” Though studies into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, speaking anonymously, says he would never use injectables in a patient because of the risks they present. “Many doctors don’t want to discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – particularly when it began moving 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 needed to finally step off the cycle of treatments. Two years later, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facelift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Then he stated, ‘We will lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|