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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of clamorous adolescent children, but because it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and drags the dermis downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are now requesting 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 Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the superficial layer, the comprehensive lift loosens the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Elevating the whole facial structure as a single unit results in a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Research have shown that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a patient because of the dangers they present. “Many doctors 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 court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facelift was the correct option 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 surgery, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|