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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous adolescent children, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their twenties and thirties – well over a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the skin – combined with the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures 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 operation du jour is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves elevating the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the companies who make filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – particularly when 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 needed to finally step off 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.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|