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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the typical causes related to a house full of loud preteen kids, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals electing to have a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing 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. “Our faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the underlying structures underneath, allowing doctors to reshape the face by moving the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Lifting 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 primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But years of using injectable gels in an attempt 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 did it because the filler ruined my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use injectables in a client because of the risks they pose. “A lot of doctors avoid discussing this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|