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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons associated with a home packed of clamorous preteen children, but because it’s the initial occasion she will reveal 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 how I look,’” states the thirty-year-old real estate agent from south Florida.

Her appearance 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 keen to stress, short-term – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy 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 appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”

You endanger operating on people that have deeper issues. 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 stretches the face and causes looseness in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails elevating the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Research have indicated that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Although research into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “A lot of doctors avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she required to exit the cycle of treatments. Two years later, she ended up choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ 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|