‘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 party. It’s not due to the typical causes associated with a house full of clamorous adolescent children, but since it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the ligaments in the face that begin to droop as we age. “Human faces are structured a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and pulls the dermis down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes looseness in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of patient towards this invasive surgery. Statistics show an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the underlying structures underneath, allowing surgeons to restructure the face by moving the deeper tissue, and preventing the taut, pulled look occasionally caused by older methods. “We’re not putting 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 underlying layers that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But years of 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 had avoided the injectable, I don’t think I would be where I’m at right now.”

If injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they pose. “Many surgeons don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|