‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of clamorous preteen children, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon 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 open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of individuals electing to have a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and drags the dermis downward with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and causes looseness in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type 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.

“People are asking now to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in 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 allows for a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although studies into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they pose. “Many surgeons don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – 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 day before her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|