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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a house full of loud preteen children, but since it’s the initial occasion she will showcase her recently altered face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for 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 bit concerned when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and drags the skin down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the skin – combined with the widespread use of slimming medications, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Statistics show an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the fact that to some extent, the face gets somewhat fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research announced. One highly regarded face specialist, speaking anonymously, says he would avoid using fillers in a patient because of the risks they present. “A lot of surgeons avoid discussing this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. After 24 months, she ended up selecting from a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|