‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the usual reasons related to a home packed of clamorous preteen children, but because it’s the initial occasion she will debut her recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, 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 among a rising count of people choosing to undergo a facelift in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the skin down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But long-term 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 desired to appear youthful,” she says. “I did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the reality that to some extent, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though studies into the area is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the risks they present. “A lot of surgeons don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, including a three-day|