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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the usual causes associated with a home packed of clamorous preteen children, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a facelift in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and pulls the skin downward 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 affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and leads to looseness in the dermis – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the deep plane facelift loosens the underlying structures underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin 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 underlying layers that is repositioned. The dermis follows along as a secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and more durable result. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “Many surgeons don’t want to talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. After 24 months, she ended up selecting from a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the correct option for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|