‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the typical causes related to a home packed of loud preteen children, but since it’s the first time she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform everyone as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via online call from her house. “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

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the tissues in the face that start to sag as we grow older. “Human faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and drags the dermis downward 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 overuse of injectable gels expands the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the UK; while a survey found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are now requesting to appear as the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to reshape the face by moving the deeper tissue, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting 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 terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the injectable ruined my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Although research into the area is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and further research initiated. One highly regarded face specialist, commenting anonymously, says he would never use injectables in a patient because of the dangers they present. “A lot of surgeons avoid talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, including a three-day|