‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical causes related to a home packed of clamorous adolescent kids, but since it’s the initial occasion she will debut her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I appear,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals choosing to have a facelift in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and pulls the dermis down 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 overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly waterlogged because its ability to drain bodily fluid has been diminished.” Although research into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies announced. An esteemed face specialist, speaking on the condition of anonymity, says he would never use injectables in a client because of the risks they present. “Many surgeons don’t want to talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to different areas 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 required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|