‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of loud adolescent children, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years prior to most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin down with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes looseness in the skin – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the underlying structures underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I regret ever done 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 cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its ability to remove bodily fluid has been diminished.” Though studies into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research announced. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of doctors don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|