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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the typical reasons associated with a house full of clamorous preteen children, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen 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 Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years prior to most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London 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 observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and pulls the skin downward with it.”

You endanger operating on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the development of new, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are now requesting to look like the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the SMAS, 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 appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent 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 in this situation right now.”

Whether injectable substances completely disappear has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that to some extent, the face gets somewhat waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they present. “A lot of doctors avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|