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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual reasons related to a house full of clamorous preteen kids, but because it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of individuals electing to have a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey found that the portion of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling doctors to restructure the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, 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 wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use injectables in a client because of the dangers they pose. “Many surgeons avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift might be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|