‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the usual reasons associated with a home packed of clamorous adolescent children, but since it’s the first time she will reveal her new face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this invasive surgery. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to look like the optimal form 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 everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the fact that in a sense, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a selection of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|