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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the typical reasons related to a house full of loud adolescent kids, but since it’s the first time she will showcase her recently altered face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this invasive surgery. Statistics show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a authentic-appearing and more durable result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable ruined my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although research into the area is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and additional studies announced. An esteemed face specialist, commenting anonymously, mentioned he would avoid using fillers in a client because of the risks they present. “A lot of surgeons don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|