‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the usual reasons related to a house full of clamorous preteen children, but since it’s the first time she will debut her new face to acquaintances and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I look,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – well over a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the dermis downward with it.”

You risk operating 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, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the dermis – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves 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 preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the injectable ruined my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that to some extent, the face gets slightly waterlogged because its capacity to remove bodily fluid has been diminished.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the dangers they present. “A lot of surgeons don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, 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 nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facelift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|