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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. It’s not due to the usual causes related to a house full of clamorous adolescent children, but because it’s the first time she will debut her new face to acquaintances and extended family. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse 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 home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before 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 treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this major operation. Reports indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied 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 ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been diminished.” Although research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they present. “A lot of surgeons avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|