‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the usual reasons related to a house full of loud preteen children, but since it’s the initial occasion she will debut her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the skin down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Statistics indicate an 8% increase in facial lifts over the last year in the UK; while a study found that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Although research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they pose. “Many doctors avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Then he stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|