‘I Couldn’t Even Open My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a home packed of clamorous adolescent kids, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a facelift in their twenties and thirties – well over a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis downward with it.”

You risk performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using injectable gels 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 clarifies. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, commenting on the condition of anonymity, says he would never use fillers in a patient because of the dangers they present. “A lot of surgeons don’t want to discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|