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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a house full of clamorous preteen kids, but since it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a facelift in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Our faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and causes laxity in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional facelift entails elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “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 results in a authentic-appearing and more durable outcome. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients 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 thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a client because of the dangers they pose. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|