‘I Wasn’t Able to Even Open My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the usual causes related to a house full of clamorous preteen children, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the first 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 home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to have a facelift in their twenties and thirties – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what ages us; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Statistics indicate an eight percent rise in facial lifts over the last year in the UK; while a survey revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – 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 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would avoid using fillers in a patient because of the risks they present. “A lot of doctors don’t want to talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing 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 – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called 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 forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived solo in Turkey, she opted to include a lip lift. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|