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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. It’s not due to the usual reasons associated with a home packed of loud adolescent kids, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not how I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first 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: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people electing to have a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” says 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 structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey found that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled look sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the whole facial structure 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 express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

Whether dermal fillers completely disappear has long been a debated topic in the cosmetic field. “Research have indicated that they seldom fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Though studies into the area is early-stage, warnings on injectables’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a patient because of the risks they present. “A lot of surgeons don’t want to discussing this, because the companies who make 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 using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to finally step off 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 surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|