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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of loud preteen kids, but since it’s the initial occasion she will showcase her recently altered face to friends and extended family. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a rising count of people electing to undergo a facelift in their twenties and thirties – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are built a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that is what ages us; that is what loosens and sags and pulls the dermis downward with it.”

You risk operating on individuals 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 injectable gels stretches the face and causes laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a new kind of customer towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a survey revealed 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 now requesting to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails lifting the SMAS, the deep plane facelift releases the underlying structures underneath, enabling surgeons to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the whole facial structure as a unified block results in a more natural-looking and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did 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 completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Although research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would never use fillers in a patient because of the dangers they present. “Many doctors avoid talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|