‘I Couldn’t Even Open My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of clamorous adolescent children, but since it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from south 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 altered – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up 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 video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and pulls the skin down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and causes laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to look like the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Although studies into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using fillers in a client because of the risks they present. “Many doctors don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d arrived solo in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|