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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons associated with a house full of clamorous adolescent children, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, 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 most doctors’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; 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 look like the best version of themselves and obviously the techniques are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. 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 outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never using it. If I didn’t have the filler, 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 aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been diminished.” Though research into the area is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded face specialist, commenting anonymously, says he would avoid using fillers in a patient because of the dangers they pose. “Many surgeons don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|