‘I Wasn’t Able to Even Open My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a house full of clamorous preteen children, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” states the 30-year-old property agent from south Florida.

How she looks is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis down with it.”

You risk operating on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and causes looseness in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the portion of younger facelift patients is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to look like 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 evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the SMAS, the deep plane facelift releases the underlying structures underneath, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers 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 young,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, speaking anonymously, mentioned he would never use injectables in a patient because of the risks they pose. “Many doctors don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down solo in Turkey, she opted to include a lip lift. “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 sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|