‘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 reasons related to a house full of loud preteen kids, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a little startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the result of six cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to most doctors’ usual candidate age of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that is what ages us; that’s what becomes lax and pulls the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “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 allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been diminished.” Although research into the area is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would never use injectables in a patient because of the dangers they present. “Many doctors don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, 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 needed to continue adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|