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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the typical reasons associated with a house full of loud adolescent children, but because it’s the first time she will reveal her new face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facelifts,” 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 bit concerned when I see individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the skin down with it.”

You endanger performing surgery on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey found that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to reshape the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I did it because the injectable harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If injectable substances completely disappear 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 block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although research into the area is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded face specialist, speaking anonymously, says he would never use fillers in a patient because of the risks they present. “A lot of surgeons don’t want to discussing this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|