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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a house full of loud adolescent children, but since it’s the initial occasion she will reveal her new face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” says the 30-year-old property agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, 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 cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a facelift in their twenties and thirties – well over a ten years prior to typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the dermis down with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the skin – alongside the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Reports indicate an eight percent rise in facial lifts over the last year in the UK; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that in a sense, the face gets somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Though research into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed face specialist, commenting 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 companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – 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 facial and neck surgery could be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|