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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical causes associated with a home packed of loud preteen children, but since it’s the initial occasion she will reveal her new face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, 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 among a growing number of people electing to undergo a facelift in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a facelift, lifts the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and drags the dermis downward with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It also means 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 “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they pose. “Many doctors don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up selecting from a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|