‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the typical reasons related to a house full of clamorous preteen children, but because it’s the first time she will showcase her new face to acquaintances and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – 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 saw me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of people electing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are built a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and drags the skin down with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and causes laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of new, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable result. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the dangers they present. “Many doctors don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d touched down alone in the country, she decided to add a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|