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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the typical reasons associated with a home packed of clamorous preteen children, but since it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the result of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to looseness 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 invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are asking now to look like the best version 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 everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional facelift involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains 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.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly waterlogged because its ability to drain bodily fluid has been diminished.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they pose. “Many surgeons don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she ended up selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|