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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a house full of clamorous adolescent kids, but because it’s the first time she will showcase her new face to acquaintances and relatives. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” states the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of individuals electing 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 most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for 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 somewhat worried when I see people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Human faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the dermis down with it.”

You risk operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Reports indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves lifting the superficial layer, the comprehensive lift releases the underlying structures underneath, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable result. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly waterlogged because its ability to remove bodily fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use fillers in a client because of the risks they pose. “A lot of surgeons avoid discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – 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 needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|