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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual causes associated with a home packed of clamorous preteen children, but because it’s the initial occasion she will showcase her recently altered 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 appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of people electing to undergo a facelift in their twenties and thirties – significantly before a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are structured a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called 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 skin down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting 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 survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails elevating the superficial layer, the deep plane facelift loosens the underlying structures underneath, allowing doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Elevating 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 rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Although studies into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a patient because of the dangers they pose. “A lot of surgeons don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, 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 the state suggested that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|