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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the usual reasons associated with a house full of loud preteen children, but because it’s the initial occasion she will showcase her new face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of individuals electing to have a facelift in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict 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 focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I see people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the dermis downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Reports show an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although studies into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a client because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in the country, she decided to add a lip lift. “Then he said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|