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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical causes related to a home packed of clamorous adolescent children, but because it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, well, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a facelift in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though 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 aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and drags the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and preventing the taut, pulled look occasionally caused by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat fluid-filled because its ability to remove bodily fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they present. “A lot of surgeons avoid discussing this, because the companies who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her 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 jawline surgery. The day before her surgery, one day after she’d arrived solo in the country, she opted to include a lip lift. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|