‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the usual causes associated with a house full of loud adolescent children, but since it’s the initial occasion she will reveal her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous 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’s how puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are built a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and leads to looseness in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” 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 secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable harmed 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 completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the area is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they pose. “Many doctors avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from 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 eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was experiencing 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 touched down solo in the country, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|