‘I Wasn’t Able to Even Unseal My Eyes. That’s The Extent of the Swelling I Was’

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the usual reasons associated with a house full of clamorous adolescent kids, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen cosmetic procedures, 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 first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people choosing to have a rhytidectomy in their 20s and 30s – well over a ten years before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

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

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. One highly regarded face specialist, speaking anonymously, says he would avoid using injectables in a patient because of the risks they present. “A lot of doctors don’t want to discussing this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – especially as 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 facial and neck surgery might be what she required to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facial lift 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 surgery, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “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.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|