‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the typical causes associated with a home packed of clamorous preteen kids, but since it’s the initial occasion she will reveal her new face to friends and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, well, a little startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of people choosing to have a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and pulls the dermis downward with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been diminished.” Although research into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a patient because of the dangers they present. “A lot of doctors don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|