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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the typical causes associated with a house full of clamorous adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not how I look,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open 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 appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a facelift in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the dermis down with it.”

You risk operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Reports show an 8% increase in facial lifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat waterlogged because its ability to remove bodily fluid has been diminished.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she required to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent 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 surgeon advised her that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|