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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the usual reasons related to a house full of loud preteen kids, but since it’s the initial occasion she will debut her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how puffy 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 attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people electing to have a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and pulls the skin down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, cut-price 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 last year in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves elevating the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they pose. “A lot of doctors don’t want to talk about this, because the companies who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate 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 surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|