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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of loud adolescent kids, but because it’s the first time she will showcase her new face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to undergo a facelift in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and drags the skin down with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice 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 laxity in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 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 injectable gels in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and further research announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they present. “Many surgeons don’t want to talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – particularly when 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 could be what she required to exit the injectable hamster wheel. Two years later, she found herself choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|