‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the usual reasons associated with a house full of clamorous preteen children, but because it’s the first time she will showcase her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people choosing to have a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the skin downward with it.”

You risk operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of younger facelift patients is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable result. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting 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 reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

Whether injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would never use fillers in a client because of the dangers they present. “Many surgeons don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she required to finally step off the cycle of treatments. Two years later, she ended up selecting from a list 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 – better known as blepharoplasty – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|