‘I Couldn’t 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. It’s not due to the typical causes associated with a home packed of loud preteen kids, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says 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 people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that begin to droop as we grow older. “Our faces are built a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is growing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using injectable gels in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. An esteemed face specialist, speaking anonymously, says he would never use fillers in a patient because of the risks they present. “Many surgeons don’t want to talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift could be what she required to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|