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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the typical reasons related to a house full of loud adolescent kids, but since it’s the initial occasion she will debut her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” says 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 see people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are structured a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the dermis down with it.”

You risk performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged 35-55.

“People are asking now to appear as the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” 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 believe I would be where I’m at currently.”

If dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes somewhat waterlogged because its ability to remove bodily fluid has been reduced.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and further research announced. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would never use injectables in a patient because of the dangers they present. “A lot of surgeons don’t want to discussing this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift might be what she required to finally step off the cycle of treatments. After 24 months, she ended up selecting from a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|