‘I Wasn’t Able to Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. Not for the typical causes associated with a house full of clamorous adolescent children, but because it’s the initial occasion she will debut her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little 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 half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a facelift, elevates the tissues in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the skin 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, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves elevating the SMAS, the comprehensive lift releases the underlying structures beneath it, allowing doctors to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched 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 deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly fluid-filled because its ability to drain bodily fluid has been diminished.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed face specialist, commenting anonymously, mentioned he would avoid using fillers in a client because of the dangers they present. “Many doctors avoid talk about this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, 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 blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d touched down solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘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 adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|