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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the typical reasons associated with a home packed of clamorous preteen children, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” states the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the tissues in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the skin – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are following,” 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

While a more traditional facelift involves lifting the superficial layer, the comprehensive lift releases the facial ligaments underneath, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, says he would never use injectables in a patient because of the dangers they pose. “Many doctors avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she ended up selecting from a selection of suggested accommodations 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 blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was finding in her face. She booked 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 lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|