‘I Wasn’t Able to Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual reasons associated with a house full of loud adolescent kids, but since it’s the initial occasion she will reveal her new face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal 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 in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a rhytidectomy in their 20s and 30s – well over a ten years prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes laxity in the skin – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Statistics show an 8% increase in facelifts over the last year in the UK; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional facelift involves elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, enabling doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

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 attempt at “facial balancing” meant that by the time she reached 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 in this situation right now.”

If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies announced. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a client because of the risks they present. “Many doctors avoid talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a selection of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|