‘My Eyes Were So Swollen I Couldn’t Even Unseal Them’

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the typical causes related to a house full of clamorous adolescent children, but because it’s the first time she will debut her new face to friends and extended family. “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.

Her appearance is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop 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 surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what ages us; that is what becomes lax and pulls the skin down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of patient towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to look like the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails lifting the superficial layer, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking anonymously, says he would avoid using fillers in a client because of the dangers they present. “A lot of surgeons avoid talk about this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d touched down alone in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|