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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. Not for the usual reasons related to a home packed of clamorous adolescent kids, but since it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw 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 home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of people electing to have a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what becomes lax and drags the dermis down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. 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 increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, 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 adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” 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 right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, commenting anonymously, mentioned he would never use fillers in a client because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, 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 local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived solo in the country, she decided to add a lip lift. “Then he stated, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|