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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the usual causes associated with a house full of loud adolescent children, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states 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 secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and pulls the dermis down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and leads to 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 surgical techniques are driving a different type of customer towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for individuals aged 35-55.

“People are asking now to look like the best version of themselves and naturally the methods 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

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

If injectable substances ever fully dissolve 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 lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they pose. “Many doctors avoid discussing this, because the manufacturers 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 replenishing it – particularly when it started to migrate 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. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|