‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the usual 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. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, allowing doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its ability to drain bodily fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they present. “A lot of surgeons avoid discussing this, because the companies who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|