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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. 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 reveal her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a facelift in their twenties and thirties – well over a decade before typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds asking for facelifts,” 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.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we age. “Human faces are built a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. 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 dermis down with it.”

You risk operating on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are asking now to look like the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Lifting 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 not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

If injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they pose. “Many doctors avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|