‘I Couldn’t Even Open My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the usual reasons related to a house full of clamorous adolescent children, but since it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to tell all guests as they come in, ‘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, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals electing to have a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see people opting for it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Our faces are built a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis 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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of new, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to look like the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched look sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed 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 dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Although studies into the topic is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research announced. One highly regarded face specialist, speaking on the condition of anonymity, says he would never use fillers in a client because of the risks they present. “Many doctors avoid talk about this, because the companies who make injectables 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 injecting filler, she felt as if she had to keep adding more – particularly when 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 needed to exit the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|