‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical causes associated with a house full of clamorous adolescent children, but because it’s the first time she will showcase her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video 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.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a facelift in their 20s and 30s – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant 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.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and pulls the skin down with it.”

You endanger operating on individuals 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 overuse of dermal fillers expands the face and causes looseness in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the methods are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the superficial layer, the deep plane facelift releases the underlying structures underneath, enabling surgeons to reshape the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face gets somewhat waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though research into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and additional studies announced. An esteemed face specialist, speaking anonymously, mentioned he would never use fillers in a client because of the dangers they pose. “Many surgeons don’t want to talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started 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 the state suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|