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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the usual causes related to a house full of clamorous adolescent kids, but because it’s the initial occasion she will debut her new face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not the way I look,’” says the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw 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 needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of people electing to have a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a facelift, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the skin down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are attracting a new kind of customer towards this major operation. Reports show an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the reality that in a sense, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

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 only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift could be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|