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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous preteen children, but since it’s the first time she will showcase her new face to acquaintances and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last 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 explains to me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to have a facelift in their 20s and 30s – significantly before a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Reports indicate an eight percent rise 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 individuals aged 35-55.

“Patients 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 method promoted 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 facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – 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,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I had avoided the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Though studies into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they present. “A lot of surgeons avoid discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when 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 required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facelift was the right solution 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 surgery, one day after she’d touched down solo in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ 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 paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|