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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the usual causes associated with a house full of loud adolescent children, but since it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and drags the dermis down with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an conscientious surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed 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 United Kingdom; while a study revealed 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 best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, allowing doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 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 years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly waterlogged because its capacity to drain bodily fluid has been reduced.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded face specialist, speaking on the condition of anonymity, says he would never use fillers in a client because of the dangers they present. “Many doctors avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|