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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual causes associated with a home packed of loud adolescent kids, but because it’s the initial occasion she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people electing to have a facelift in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and drags the skin down with it.”

You endanger operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a unified block allows for a more natural-looking and more durable result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But long-term using injectable gels in an attempt 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 youthful,” she says. “I did it because the filler harmed my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its ability to remove bodily fluid has been reduced.” Though research into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use injectables in a client because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|