‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. Not for the typical causes associated with a house full of loud adolescent children, but since it’s the first time she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon 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: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as 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 skin down with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the skin – combined with the common adoption of slimming medications, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Reports indicate 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 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling doctors to reshape the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Although studies into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use fillers in a client because of the risks they pose. “A lot of doctors avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, 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 needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. Two years later, she found herself selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|