‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the typical reasons associated with a home packed of clamorous preteen kids, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the result of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her home. “I needed to inform 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 one of a growing number of people choosing to have a facelift in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states 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 see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the development of new, celebrity-endorsed surgical techniques are driving a new kind of customer 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 percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If dermal fillers completely disappear 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 obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Although studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the dangers they present. “Many surgeons avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|