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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. It’s not due to the usual causes related to a house full of loud adolescent kids, but since it’s the initial occasion she will reveal her new face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for 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 built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and leads to looseness in the skin – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the last year in the UK; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting result. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the filler harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its ability to remove bodily fluid has been diminished.” Though research into the area is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, says he would never use fillers in a patient because of the risks they present. “A lot of doctors don’t want to talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facial lift 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 operation, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|