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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the usual causes related to a house full of loud preteen children, but since it’s the first time she will showcase her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails lifting the superficial layer, the deep plane facelift releases the facial ligaments beneath it, enabling surgeons to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Lifting the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “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 using it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly waterlogged because its capacity to remove bodily fluid has been diminished.” Although research into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a patient because of the dangers they pose. “Many surgeons don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended 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 jawline surgery. The eve of her surgery, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘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 adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|