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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual reasons associated with a home packed of clamorous preteen kids, but since it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what becomes lax and drags the dermis down with it.”

You risk performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Although studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research announced. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the dangers they present. “Many surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|