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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the typical causes related to a home packed of clamorous adolescent kids, but because it’s the first time she will reveal her new face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to 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 jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number 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 many specialists are eager to highlight the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon 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 becomes lax and drags the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the skin 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 deeper tissue that is repositioned. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But long-term using injectable gels in an effort 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 youthful,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face becomes slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Although research into the area is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use fillers in a client 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 pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. Two years later, she found herself choosing between a selection of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in the country, 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 remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|