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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a home packed of loud preteen children, but because it’s the initial occasion she will debut her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the first 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 had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Though 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,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the United Kingdom; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the methods are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” 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 passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – 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 reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has long been a debated topic in the cosmetic field. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although research into the topic is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, speaking 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 companies who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her 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 operation, 24 hours post she’d touched down solo in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|