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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a house full of loud preteen children, but because it’s the first time she will showcase her recently altered face to friends and extended family. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people choosing to have a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the development of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a survey revealed that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

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

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to reshape the face by moving the deeper tissue, 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,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face gets somewhat fluid-filled because its capacity to drain lymphatic fluid has been diminished.” 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. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the dangers they pose. “A lot of doctors avoid talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down alone in the country, she decided to add a lip lift. “Then he stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|