‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a home packed of clamorous adolescent kids, but because it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of people electing to have a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and pulls the skin downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and causes looseness in the skin – combined with the widespread use of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the superficial layer, the deep plane facelift loosens the underlying structures underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face gets slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Although studies into the area is early-stage, warnings on injectables’ potential impact on the body’s drainage have been released, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they present. “Many surgeons avoid talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

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