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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical causes related to a house full of loud adolescent children, but since it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people electing to have a facelift in their twenties and thirties – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments 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. “Skin and fat 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’s what causes aging; that is what loosens and sags and drags the dermis down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on 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 authentic-appearing and longer-lasting result. It also means that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t think I would be in this situation right now.”

Whether injectable substances completely disappear has long been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Though research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “A lot of surgeons don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was finding 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 arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|