‘I Couldn’t Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the usual reasons related to a home packed of clamorous preteen kids, but because it’s the first time she will showcase her new face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. 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 20s and 30s – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, 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 focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the skin down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and naturally the methods are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting result. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent 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 currently.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that to some extent, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Although studies into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use fillers in a client because of the risks they pose. “Many surgeons avoid talk about this, because the manufacturers 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 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 local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she found herself selecting from a selection of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – 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 arranged a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|