‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the typical causes associated with a house full of clamorous preteen kids, but since it’s the initial occasion she will showcase her new face to friends and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how 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 look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the skin down with it.”

You risk operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. 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 conducted for individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves lifting the superficial layer, the deep plane facelift releases the facial ligaments beneath it, enabling surgeons to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting outcome. 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 receive many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Though research into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been released, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a client because of the dangers they present. “Many surgeons don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|