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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the usual reasons associated with a house full of clamorous adolescent kids, but because it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people electing to have a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the underlying structures underneath, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, 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 purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt 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 ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated 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 gets slightly waterlogged because its capacity to remove bodily fluid has been diminished.” Although research into the area is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would never use fillers in a patient because of the risks they pose. “Many doctors avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she required to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|