‘My Eyes Were So Puffy I Couldn’t Even Open Them’

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes related to a house full of clamorous preteen kids, but because it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, 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 electing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Reports show 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 increasing, with one-third of procedures now performed on individuals aged 35-55.

“People are now requesting to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It additionally implies 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 clients 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 injectable gels in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “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 right now.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to drain bodily fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using fillers in a client because of the risks they present. “Many surgeons don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|