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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the typical reasons associated with a house full of loud preteen children, but since it’s the initial occasion she will reveal her new face to friends and relatives. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, well, a little startling – her face puffed up 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 half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” says 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 bit concerned when I observe individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and drags the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not advisable for an conscientious surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the last year 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.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched look occasionally caused by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the primary goal 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 reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the fact that to some extent, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Though research into the area is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and additional studies initiated. An esteemed face specialist, commenting anonymously, says he would avoid using fillers in a patient because of the risks they present. “Many doctors avoid talk about this, because the companies who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|