‘My Eyes Were So Puffy I Was Unable to Even Open Them’

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the typical causes related to a house full of loud preteen kids, but since it’s the first time she will reveal her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little 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 – look is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds requesting facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and drags the skin down with it.”

You risk performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on patients aged 35-55.

“People are asking now to appear as the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to restructure the face by repositioning the deeper tissue, and preventing 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 underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. 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 also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though research into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a patient because of the dangers they pose. “Many doctors don’t want to talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders 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 started to migrate to different areas 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 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 surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the correct option for the laxity she was finding 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 decided to add a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|