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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the typical causes related to a house full of loud adolescent kids, but since it’s the first time she will reveal her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-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 eager to emphasize, short-term – look is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and drags the skin downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to restructure the face by moving the deeper tissue, 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 underlying structures,” says Harley Street cosmetic doctor 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 unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never using it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they migrate 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 slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although research into the area is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the risks they present. “Many surgeons avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she found herself selecting from a selection of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will lift 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 procedures,” she says. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|