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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the usual causes associated with a home packed of clamorous adolescent kids, but since it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the skin downward with it.”

You risk operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting stress 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 deeper tissue that is repositioned. 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 not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never done 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. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its capacity to remove bodily fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would never use fillers in a client because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate 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 might be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|