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

Amanda Preisinger feels anxious about her daughter’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 reveal her new face to acquaintances and extended family. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional 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 online call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels stretches the face and leads to laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the superficial layer, the deep plane facelift releases the facial ligaments beneath it, enabling surgeons to restructure the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “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 more natural-looking and longer-lasting outcome. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that in a sense, the face becomes slightly waterlogged because its ability to drain bodily fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift could be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to lift 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 procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|