‘My Eyes Were So Swollen I Was Unable to Even Unseal Them’

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. It’s not due to the usual causes associated with a home packed of loud preteen kids, but since it’s the first time she will debut her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human faces are built a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls the skin downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this major operation. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the underlying structures underneath, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the reality that to some extent, the face gets slightly fluid-filled 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. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they present. “A lot of doctors avoid talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her operation, one day after she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|