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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons associated with a house full of clamorous preteen children, but since it’s the first time she will debut her new face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are structured a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and pulls the dermis down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a new kind of patient towards this invasive surgery. Statistics show an eight percent rise in facelifts over the last year in the UK; while a survey found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But years of using injectable gels in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have shown 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 term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a client because of the risks they present. “Many surgeons don’t want to talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed 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 could be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d arrived alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove 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 half-day surgery, plus a three-day|