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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the usual reasons associated with a house full of loud adolescent kids, but because it’s the initial occasion she will showcase her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat 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 result of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the skin down with it.”

You endanger operating on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the skin – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever 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 historically been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research announced. One highly regarded face specialist, commenting anonymously, says he would never use injectables in a client because of the dangers they present. “A lot of surgeons avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

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 Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for 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 brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down alone in the country, she decided to add a lip lift. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|