‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the typical causes associated with a home packed of loud adolescent kids, but because 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 look,’” says the thirty-year-old property agent from south Florida.

Her appearance is, well, 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, short-term – appearance is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the first 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 needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to have a rhytidectomy in their twenties and thirties – significantly before a ten years prior to most doctors’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Reports show 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 increasing, 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 following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Though studies into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using fillers in a patient because of the dangers they pose. “Many surgeons avoid talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed 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 list of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – 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 forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|