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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the usual reasons related to a house full of loud preteen children, but since 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 arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of individuals electing to have a facelift in their 20s and 30s – well over a decade before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. 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 dermis down with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Reports show an 8% increase in facial lifts 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 individuals aged thirty-five to fifty-five.

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

Deep Plane Technique

Where a conventional facelift entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Lifting the whole facial structure 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 rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” 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 clarifies. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face gets slightly waterlogged because its ability to remove bodily fluid has been diminished.” Although research into the area is preliminary, warnings on dermal fillers’ possible effects 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 never use injectables in a patient because of the dangers they present. “Many doctors avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she required to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|