‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the usual reasons related to a house full of loud adolescent children, but since it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I look,’” states the thirty-year-old property agent from south Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a facelift in their twenties and thirties – well over a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and pulls the dermis down with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an conscientious 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, cut-price medical tourism, and the development of new, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely 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 in a sense, the face gets slightly fluid-filled because its capacity to remove bodily fluid has been diminished.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a patient because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d arrived alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|