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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of clamorous adolescent children, but because it’s the initial occasion she will showcase her new face to friends and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called 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 drags the dermis downward with it.”

You endanger 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 overuse of dermal fillers expands the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the facial ligaments underneath, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been diminished.” Though research 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, commenting on the condition of anonymity, says he would never use fillers in a client because of the dangers they pose. “Many surgeons don’t want to discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

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 the state suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift 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 eve of her operation, 24 hours post she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|