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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical reasons related to a home packed of loud preteen children, but since it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals electing to have a facelift in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and pulls the skin 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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the UK; while a study found that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and naturally the methods are evolving,” comments 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 facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – 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 undergo this because I wanted to look young,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its ability to drain bodily fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a patient because of the risks they present. “Many surgeons don’t want to discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – 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 might be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled 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 booked a forehead lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d touched down alone in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|