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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical causes related to a home packed of clamorous preteen children, but because it’s the initial occasion she will debut her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to 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 attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of people choosing to have a facelift in their 20s and 30s – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic 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 see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a study revealed that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a client because of the risks they present. “Many surgeons avoid discussing this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|