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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the typical causes related to a home packed of loud preteen kids, but since it’s the initial occasion she will debut her recently altered face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the skin – combined with the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a different type of customer towards this major operation. Statistics indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are now requesting to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the SMAS, the deep plane facelift loosens the facial ligaments underneath, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” 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 where I’m at right now.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face becomes slightly waterlogged because its capacity to remove bodily fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would never use injectables in a patient because of the dangers they present. “Many surgeons avoid discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift could be what she needed to exit the cycle of treatments. Two years later, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|