‘I Couldn’t Even Open My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes associated with a house full of loud preteen kids, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together 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 endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he saw 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 video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient 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 percentage of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the SMAS, the deep plane facelift loosens the facial ligaments underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re going below, 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 dermis follows along as a secondary element.” Lifting the whole facial structure as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the fact that in a sense, the face gets slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research announced. An esteemed face specialist, commenting anonymously, says he would avoid using injectables in a patient because of the risks they present. “Many doctors don’t want to discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to finally step off 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 doctor advised her that a facelift was the correct option for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d touched down alone in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I think if we remove some cheek 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 half-day surgery, plus a three-day|