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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the typical reasons associated with a house full of clamorous adolescent children, but since it’s the first time she will showcase her new face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of individuals electing to have a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are built a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift releases the underlying structures underneath, enabling surgeons to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” says 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 attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Though research into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would never use fillers in a client because of the dangers they pose. “A lot of doctors don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facelift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, 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.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|