‘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 celebration. It’s not due to the usual reasons related to a house full of clamorous preteen kids, but because it’s the initial occasion she will showcase her new face to friends and relatives. “Obviously I’m going to tell everyone 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, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, 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 one of a rising count of people electing to have a facelift in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin 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 moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to looseness in the skin – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this major operation. Reports indicate an eight percent rise in facial lifts over the last year in the UK; while a survey revealed that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling surgeons to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes 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 “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block 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 capacity to drain lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use fillers in a client because of the risks they pose. “A lot of surgeons avoid talk about this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed 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 choosing between a selection of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the looseness she was experiencing 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 alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|