‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the usual causes related to a home packed of clamorous preteen kids, but because it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a somewhat startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to undergo a rhytidectomy in their twenties and thirties – 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 industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – 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 development of new, famous-figure-promoted surgical techniques are driving a different type of customer towards this invasive surgery. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey found that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing surgeons to restructure the face by moving the deeper tissue, and preventing the taut, pulled look occasionally caused by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels 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 young,” she says. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Though studies into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research announced. One highly regarded face specialist, commenting anonymously, says he would avoid using injectables in a patient because of the dangers they pose. “A lot of surgeons avoid discussing this, because the companies who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. After 24 months, she ended up selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|