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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the typical reasons associated with a house full of loud adolescent children, but because it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the skin downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the whole facial structure as a unified block results in a more natural-looking and more durable result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo 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 filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although research into the topic is early-stage, warnings on injectables’ possible effects on the body’s drainage have been released, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would never use injectables in a patient because of the risks they pose. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|