‘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. Not for the usual reasons associated with a home packed of loud preteen kids, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old property agent from south 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 keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are built a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the dermis down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey found that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance sometimes wrought by older methods. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. 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 facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and additional studies initiated. One highly regarded face specialist, speaking anonymously, mentioned he would never use fillers in a client because of the risks they present. “A lot of doctors avoid discussing this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she required to finally step off the cycle of treatments. After 24 months, she ended up choosing between a selection of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|