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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. 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 recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and pulls the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a new kind of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to look like the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors 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 stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat waterlogged because its ability to drain lymphatic fluid has been diminished.” Although research into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been released, and further research announced. An esteemed face specialist, commenting anonymously, says he would avoid using injectables in a patient because of the dangers they pose. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. Two years later, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he stated, ‘We will lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|