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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the usual causes related to a home packed of loud adolescent kids, but since it’s the first time she will showcase her new face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to have a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds asking for facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are built a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the dermis downward with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, enabling doctors to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

If 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 fully dissipate,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face gets somewhat fluid-filled because its ability to remove bodily fluid has been diminished.” Though studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use injectables in a client because of the dangers they pose. “A lot of surgeons avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state 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 choosing between a selection of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|