‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. It’s not due to the typical reasons related to a house full of loud preteen kids, but since it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional 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 house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ usual candidate age 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 requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the skin downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a survey found that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable result. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Although studies into the topic is early-stage, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “A lot of doctors don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, 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 right solution for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|