‘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 impending 13th birthday party. It’s not due to the usual reasons related to a house full of loud adolescent children, but since it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the dermis – combined with the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves lifting the superficial layer, the comprehensive lift releases the underlying structures underneath, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Lifting the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been diminished.” Though research into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “Many doctors don’t want to talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facial lift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|