‘My Eyes Were So Puffy I Couldn’t Even Open Them’

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a house full of clamorous adolescent kids, but because it’s the first time she will debut her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I appear,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals electing to have a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the dermis downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional facelift involves elevating the superficial layer, the deep plane facelift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing 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 describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at least not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its ability to drain bodily fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ possible effects on the body’s drainage have been released, and further research initiated. One highly regarded face specialist, commenting anonymously, says he would never use injectables in a patient because of the risks they pose. “Many surgeons don’t want to talk about this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. Two years later, she found herself selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down solo in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|