‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical causes associated with a home packed of loud preteen children, but since it’s the first time she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘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, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, 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 one of a growing number of people electing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that begin to droop as we age. “Human faces are structured a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and drags the skin down with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant 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 did it because the injectable ruined my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has long been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat waterlogged because its ability to remove bodily fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and further research initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they pose. “A lot of surgeons avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when 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 could be what she needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|