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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of loud adolescent kids, but since it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the first 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 house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of individuals electing to have a facelift in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin downward with it.”

You risk operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a new kind of patient towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift involves elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling 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 skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” 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 surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the injectable ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

Whether injectable substances ever fully dissolve has historically 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 obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the reality that to some extent, the face gets slightly waterlogged because its ability to drain bodily fluid has been diminished.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “A lot of doctors avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to different areas 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 required to finally step off the injectable hamster wheel. 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 planned for an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|