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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the usual causes associated with a home packed of clamorous adolescent children, but since it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells 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.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and drags the skin downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found 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 optimal form of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It additionally implies that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to remove bodily fluid has been reduced.” Although research into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a patient because of the risks they present. “A lot of doctors avoid discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift could be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|