‘My Eyes Were So Puffy I Couldn’t Even Unseal Them’

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the usual reasons associated with a house full of loud preteen children, but because it’s the first time she will showcase her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to have a facelift in their 20s and 30s – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin down with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, cut-price surgical travel, and the development of new, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Reports show 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 performed on individuals aged thirty-five to fifty-five.

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

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But years of 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 undergo this because I wanted to look young,” she says. “I did it because the injectable harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded face specialist, speaking anonymously, says he would avoid using fillers in a patient because of the risks they present. “A lot of doctors don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called 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 cheek lift and a neck lift. The day before her operation, 24 hours post she’d touched down alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|