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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a home packed of loud preteen kids, but because it’s the initial occasion she will debut her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to have a facelift in their twenties and thirties – significantly before a ten years prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and drags the skin downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the skin – alongside the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum 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 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that in a sense, the face gets slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “Many doctors avoid discussing this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she required to exit the injectable hamster wheel. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facial lift 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 touched down alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|