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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the usual causes associated with a house full of loud adolescent children, but because it’s the first time she will reveal her new face to friends 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 30-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – 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 – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of people electing to have a rhytidectomy in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer 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 is what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the dermis – alongside the widespread use of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

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 attempt at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though studies into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, speaking anonymously, says he would avoid using fillers in a client because of the dangers they present. “A lot of doctors avoid discussing this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she needed to exit the cycle of treatments. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the correct option 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 alone in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|