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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual reasons associated with a house full of clamorous preteen children, but since it’s the initial occasion she will showcase her new face to friends and extended family. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to have a facelift in their 20s and 30s – well over a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the dermis down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and leads to looseness in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts 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 performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional facelift entails lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to reshape the face by repositioning 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 underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it 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 cosmetic field terms it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Research have shown that they seldom fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “A lot of doctors avoid discussing this, because the companies who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested 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 the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|