‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a home packed of clamorous adolescent children, but since it’s the initial occasion she will debut her new face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” states based in London aesthetic plastic 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 choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

You endanger performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and causes looseness in the dermis – alongside the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional facelift involves elevating the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled look sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that in a sense, the face becomes 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 lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they present. “Many surgeons avoid discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – 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 arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived alone in the country, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|