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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the usual reasons related to a home packed of loud adolescent children, 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,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of people choosing to have a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that is what becomes lax and pulls the dermis down with it.”

You endanger operating on people that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the dermis – alongside the widespread use of slimming medications, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study found that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded face specialist, speaking anonymously, mentioned he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors don’t want to discussing this, because the companies who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed 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 nearby cosmetic doctor in Florida suggested that a face and neck lift could be what she needed to finally step off the cycle of treatments. After 24 months, she ended up selecting from a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged 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 opted to include a mouth enhancement. “Then he 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 including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|