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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. It’s not due to the usual causes related to a home packed of clamorous adolescent children, but because it’s the initial occasion she will debut her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. 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 people choosing to undergo a facelift in their twenties and thirties – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the dermis downward with it.”

You endanger operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Statistics indicate an eight percent rise in facial lifts over the last year in the UK; while a study found that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Research have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes somewhat waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would avoid using injectables in a patient because of the dangers they pose. “Many doctors don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Then he said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|