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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the typical causes associated with a home packed of clamorous preteen children, but since it’s the first time she will debut her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” states London-based 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 bit concerned when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the whole facial structure as a unified block allows for a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though research into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, says he would never use injectables in a client because of the dangers they pose. “A lot of doctors don’t want to talk about 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, once she started using injectables, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|