‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons related to a home packed of loud adolescent children, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of people choosing to have a facelift in their twenties and thirties – significantly before a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and causes looseness 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 attracting a different type of patient towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the UK; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a client because of the risks they present. “A lot of surgeons don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed 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 choosing between a list of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d touched down alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|