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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the typical reasons associated with a house full of loud adolescent children, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and relatives. “Obviously I’m going to inform everyone 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, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor 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 unseal my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to have a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says 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 observe people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and drags the dermis downward with it.”

You endanger operating on people that have deeper issues. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” 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 “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I did it because the filler 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 currently.”

If injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is additionally the reality that in a sense, the face becomes somewhat waterlogged because its capacity to drain bodily fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use injectables in a client because of the dangers they pose. “Many surgeons don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

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 other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will contour 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, plus a three-day|