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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. It’s not due to the typical causes related to a house full of loud adolescent kids, but because it’s the initial occasion she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals electing to have a facelift in their 20s and 30s – well over a decade before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the skin down with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face becomes somewhat waterlogged because its capacity to remove lymphatic fluid has been diminished.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors avoid talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – especially as it began moving to different areas 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 cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|