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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the usual causes related to a house full of loud adolescent children, but because it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

How she looks is, well, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of six aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via online call from her home. “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 plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. 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 advisable for an conscientious surgeon to follow

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 common adoption of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting result. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “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 didn’t have the injectable, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though research into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. An esteemed face specialist, commenting on the condition of anonymity, says he would never use fillers in a client because of the dangers they pose. “Many doctors avoid discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will lift 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 surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|