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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. Not for the typical causes related to a house full of clamorous preteen kids, but since it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are structured a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the skin 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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are attracting a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, 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,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to remove bodily fluid has been reduced.” Though studies into the area is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. An esteemed face specialist, speaking anonymously, mentioned he would never use injectables in a client because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon 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 selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|