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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical causes associated with a home packed of loud preteen kids, but because it’s the first time she will reveal her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, 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 people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see 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. “Human faces are built a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to laxity in the skin – combined with the widespread use of slimming medications, cut-price medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this major operation. Statistics show an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling surgeons to restructure the face by moving the deeper tissue, and preventing the tight, stretched look sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies 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 becomes slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Though studies into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the dangers they pose. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|