‘I Wasn’t Able to 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 usual causes related to a house full of clamorous adolescent children, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first 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: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the dermis 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 moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable result. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be in this situation right now.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they present. “A lot of surgeons avoid discussing this, because the companies who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it began moving 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 required to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|