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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes related to a house full of clamorous preteen children, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not the way I appear,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of people choosing to have a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and drags the skin downward with it.”

You endanger operating on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

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 widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the UK; while a survey found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting result. It also means that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though research into the topic is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they pose. “A lot of surgeons don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|