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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the typical reasons related to a home packed of clamorous adolescent kids, but because it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by moving the underlying layers, 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 deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” meant 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 did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its capacity to remove bodily fluid has been reduced.” Though research into the area is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the dangers they present. “A lot of surgeons avoid discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|