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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the usual causes associated with a home packed of clamorous preteen children, but because it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse 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 tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, 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 electing to have a rhytidectomy 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 keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Our faces are built a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the dermis down with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised 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, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” 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 filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that to some extent, the face becomes slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a client because of the risks they present. “Many surgeons don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing 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 – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|