‘I Wasn’t Able to Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a home packed of loud preteen kids, but because it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals electing to undergo a facelift in their 20s and 30s – significantly before a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that is what ages us; that is what loosens and sags and drags the dermis down with it.”

You risk performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by moving the deeper tissue, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided 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 aesthetics industry. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although studies into the topic is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and additional studies initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they present. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, 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 suggested that a face and neck lift might be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d arrived alone in the country, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour 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|