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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. It’s not due to the typical reasons related to a house full of loud adolescent kids, but since it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, 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. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the skin downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It additionally implies that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have shown that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the fact that to some extent, the face becomes slightly waterlogged because its ability to remove bodily fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would never use fillers in a client because of the risks they pose. “Many surgeons avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a list of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|