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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the usual causes related to a house full of loud preteen kids, but since it’s the first time she will debut her new face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity 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 before typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Human faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis down with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, 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 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the portion 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 naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails elevating the SMAS, the deep plane facelift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by older methods. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” 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 effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

If injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its capacity to drain bodily fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of doctors avoid talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep 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 finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|