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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the typical causes associated with a house full of loud preteen kids, but because it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old property agent from south Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade 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, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a facelift in their 20s and 30s – well over a decade before most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the UK; while a study revealed that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“People are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. 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 says. “I underwent it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have shown 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 also the fact that to some extent, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Although research into the area is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they present. “Many doctors avoid discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|