‘My Eyes Were So Swollen I Couldn’t Even Unseal Them’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the typical causes associated with a house full of loud adolescent kids, but because it’s the initial occasion she will reveal her new 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 look,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of people electing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the dermis down with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the skin – combined with the common adoption of slimming medications, cut-price surgical travel, and the development of novel, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says 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 passenger.” Lifting the whole facial structure as a unified block results in a more natural-looking and more durable result. It also means that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the fact that to some extent, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and further research initiated. An esteemed 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 surgeons don’t want to talk about this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to exit the cycle of treatments. Two years later, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was experiencing 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 touched down alone in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|