‘My Eyes Were So Puffy I Was Unable to Even Unseal Them’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual reasons related to a home packed of clamorous preteen children, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I appear,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people choosing to have a facelift in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds requesting facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the skin downward with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes laxity in the dermis – combined with the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Statistics indicate an eight percent rise in facial lifts 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 now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

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 youthful,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that in a sense, the face gets slightly waterlogged because its capacity to remove lymphatic fluid has been diminished.” Though studies into the area is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “Many surgeons avoid talk about this, because the manufacturers 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 injecting filler, she believed she had to keep adding more – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|