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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the typical causes associated with a home packed of loud adolescent children, but because it’s the initial occasion she will debut her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals choosing to have a facelift in their 20s and 30s – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis down with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to looseness in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable outcome. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although research into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the risks they present. “Many doctors avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she required to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facial lift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|