‘I Wasn’t Able to 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 typical reasons related to a home packed of loud preteen children, but because it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not the way I look,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the tissues in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the skin downward with it.”

You risk operating on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are now requesting to look like the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the superficial layer, the comprehensive lift 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 avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for 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’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that in a sense, the face becomes slightly fluid-filled because its capacity to remove bodily fluid has been diminished.” Though research into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies announced. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a patient because of the risks they pose. “A lot of surgeons don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in the country, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|