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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of clamorous adolescent children, but because it’s the first time she will reveal 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 appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I needed to inform 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 one of a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds asking for facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major procedure, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are structured a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and drags the skin downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of slimming medications, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

If dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the fact that to some extent, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though studies into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using fillers in a client because of the dangers they pose. “Many surgeons avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift might be what she needed to exit the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in the country, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|