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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes associated with a home packed of loud adolescent children, but because it’s the first time she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a facelift in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Explaining 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 structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the dermis down with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and leads to looseness in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to appear as the best version of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face gets somewhat waterlogged because its capacity to drain bodily fluid has been reduced.” Although studies into the area is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would never use injectables in a patient because of the risks they present. “A lot of doctors don’t want to talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was finding 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 arrived alone in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ 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 (£16,500) for the half-day operation, plus a three-day|