‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the typical causes related to a house full of loud preteen children, but since it’s the first time she will debut her recently altered face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – 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 – look is the result of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis down with it.”

You risk operating on individuals that have deeper issues. It’s not a practice 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 dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is not just being used for the primary goal 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 reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated 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 ‘puffy appearance’ is also the reality that in a sense, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ possible effects on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they pose. “A lot of doctors avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, 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 nearby cosmetic doctor in the state proposed that a face and neck lift could be what she needed to finally step off the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option 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 surgery, 24 hours post she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|