‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the typical reasons associated with a house full of clamorous adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people electing to have a rhytidectomy in their 20s and 30s – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a facelift, elevates the tissues in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and drags the dermis down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails lifting the superficial layer, the comprehensive lift releases the facial ligaments underneath, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” explains prestigious London 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 secondary element.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe 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 shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though studies into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. An esteemed face specialist, speaking anonymously, mentioned he would avoid using fillers in a client because of the dangers they pose. “Many surgeons avoid talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|