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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. It’s not due to the typical causes associated with a home packed of loud adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, 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 face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the superficial layer, the deep plane facelift releases the facial ligaments underneath, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on 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 unified block results in a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a patient because of the dangers they pose. “Many doctors don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon 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 neck lift. The eve of her surgery, one day after she’d touched down solo in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|