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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of loud adolescent kids, but because it’s the initial occasion she will reveal her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old property agent from Southern 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, short-term – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of people choosing to undergo a facelift in their twenties and thirties – significantly before a ten years prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are built a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that is what ages us; that is what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied 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 filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at right now.”

If injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed face specialist, speaking anonymously, says he would avoid using fillers in a patient because of the risks they pose. “A lot of surgeons avoid discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested 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 selecting from a selection of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facelift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|