‘I Couldn’t Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a home packed of loud preteen kids, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of people electing to have a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and pulls the skin downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension on the skin 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 deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, speaking anonymously, mentioned he would never use fillers in a client because of the risks they present. “Many doctors avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – 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 finally step off the cycle of treatments. After 24 months, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in the country, she decided to add a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|