‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the typical reasons associated with a house full of loud preteen children, but because it’s the first time she will debut her recently altered face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of individuals electing to have a facelift in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London 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 see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Human faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and pulls the skin downward with it.”

You risk operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Reports indicate an 8% increase in facelifts over the last year in the UK; while a survey revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, 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 adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It additionally implies that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been reduced.” Though research into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a client because of the risks they pose. “A lot of doctors avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|