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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the usual reasons associated with a home packed of loud preteen kids, but since it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of individuals electing to have a facelift in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and causes laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey found that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the underlying structures underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

Whether dermal fillers 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 move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Though research into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been released, and additional studies initiated. An esteemed face specialist, speaking anonymously, says he would never use injectables in a client because of the risks they present. “A lot of doctors don’t want to talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|