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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual causes related to a house full of loud preteen children, but because it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, 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’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a ten years prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the skin downward with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves lifting the superficial layer, the comprehensive lift loosens the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

If injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets slightly waterlogged because its ability to remove bodily fluid has been diminished.” Although studies into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been released, and additional studies initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would never use fillers in a client because of the risks they present. “Many doctors avoid discussing this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon 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 operation, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, including a three-day|