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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. It’s not due to the usual reasons associated with a house full of clamorous adolescent kids, but since it’s the initial occasion she will reveal her new face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of individuals electing to undergo a facelift in their twenties and thirties – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the dermis – combined with the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

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

Advanced Lifting Method

Where a more traditional facelift entails elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “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 using it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Although research into the area is early-stage, warnings on injectables’ potential impact on the body’s drainage have been released, and further research initiated. An esteemed face specialist, commenting anonymously, says he would never use injectables in a patient because of the risks they present. “A lot of doctors don’t want to talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift might be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a selection of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|