‘I Wasn’t Able to Even Open My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a home packed of clamorous preteen children, but since it’s the initial occasion she will debut her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I wasn’t able to 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 hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals electing to have a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, 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 ages us; that’s what becomes lax and pulls the skin down with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the methods are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London 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.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and more durable result. It also means that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Although studies into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed 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 surgeons don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|