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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons associated with a home packed of clamorous preteen children, but because it’s the first time she will debut her new face to friends and extended family. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, including 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 initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people electing to have a facelift in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the dermis downward with it.”

You endanger operating on people that have deeper issues. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient towards this invasive surgery. Reports show an eight percent rise in facelifts over the last year in the UK; while a study found that the portion of younger facelift patients is increasing, 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 evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the underlying structures underneath, enabling doctors to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat waterlogged because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they present. “A lot of doctors avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the correct option for the laxity she was finding in her face. She arranged a forehead 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 lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|