‘My Eyes Were So Swollen I Was Unable to Even Unseal Them’

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the usual causes associated with a house full of loud adolescent children, but because it’s the first time she will reveal her new face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to undergo a facelift in their twenties and thirties – well over a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that is what becomes lax and pulls the skin downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling doctors to reshape the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Elevating the whole facial structure 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 primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum 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 entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face becomes somewhat waterlogged because its capacity to remove lymphatic fluid has been reduced.” Although research into the area is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a patient because of the dangers they pose. “Many doctors avoid discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she required to exit 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.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|