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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the typical causes associated with a house full of loud adolescent kids, but because it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t 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 jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people electing to have a facelift in their twenties and thirties – well over a decade before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are driving a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to restructure the face by moving the deeper tissue, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although research into the area is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed face specialist, commenting anonymously, says he would never use injectables in a patient because of the risks they pose. “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 plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts 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 needed to exit the cycle of treatments. Two years later, she ended up choosing between a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

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 mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|