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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the typical causes related to a house full of loud adolescent kids, but since it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of half a dozen aesthetic surgeries, including 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 initial time because I wasn’t able to 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: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people electing to have a facelift in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” 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 see individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and pulls the dermis downward with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and causes looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “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 deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Though research into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using fillers in a client because of the risks they pose. “A lot of surgeons don’t want to discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she ended up choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate 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 says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|