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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the typical causes related to a house full of loud adolescent children, but because it’s the initial occasion she will debut her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the skin downward with it.”

You risk operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and causes looseness in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on patients aged 35-55.

“People 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 method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and more durable result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face becomes somewhat waterlogged because its capacity to remove bodily fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and additional studies initiated. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|