‘I Couldn’t Even Open My Eyes. That’s How Swollen I Was’

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of loud preteen children, but since it’s the initial occasion she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen 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 first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to have a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and drags the skin downward with it.”

You endanger performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey found that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged 35-55.

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

Deep Plane Technique

Where a conventional facelift entails lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting 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 minimum not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face gets somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a client because of the risks they pose. “Many doctors don’t want to discussing this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|