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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of loud preteen children, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of individuals electing to have a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the facial ligaments underneath, enabling doctors to reshape the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It also means that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – 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 entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been diminished.” Though research into the area is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they present. “A lot of doctors avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon 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.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|