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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the typical reasons related to a home packed of clamorous adolescent children, but because it’s the first time she will debut her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to have a facelift in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes looseness in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are now requesting to look like the optimal form of themselves and naturally the methods 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.

Advanced Lifting Method

While a more traditional facelift involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Elevating the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the filler harmed 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 right now.”

If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research announced. An esteemed face specialist, commenting anonymously, mentioned he would never use fillers in a patient because of the dangers they present. “A lot of doctors avoid discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she ended up selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facelift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d touched down solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|