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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the typical reasons related to a house full of clamorous adolescent children, but since it’s the initial occasion she will reveal her new face to friends and relatives. “Obviously I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We address genetics, not years.”) “I have 28-year-olds requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and drags the skin down with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the dermis – alongside the widespread use of slimming medications, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“People are now requesting to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift releases the facial ligaments underneath, enabling surgeons to restructure the face by repositioning the deeper tissue, and preventing 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,” says prestigious London 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.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

If injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use injectables in a patient because of the dangers they pose. “A lot of doctors avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift could be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|