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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the usual reasons associated with a house full of clamorous preteen kids, but since it’s the first time she will reveal her new face to friends and relatives. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, 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 known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the dermis down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are now requesting to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling doctors to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched appearance occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the filler harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use fillers in a client because of the risks they pose. “Many surgeons don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. After 24 months, she ended up choosing between a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facial lift was the correct option 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 surgery, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|