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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. Not for the usual reasons related to a house full of loud adolescent kids, but because it’s the initial occasion she will reveal her new face to friends and relatives. “Obviously 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 real estate agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a facelift in their twenties and thirties – well over a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this major operation. Reports indicate an 8% increase in facelifts over the last year in the UK; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling doctors to restructure the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

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 reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I did 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 right now.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, speaking on the condition of anonymity, says he would never use injectables in a patient because of the dangers they present. “A lot of doctors avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|