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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes related to a home packed of clamorous adolescent children, but because it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I look,’” states the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the first time because I couldn’t even open my eyes. That indicates 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 attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. 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 more durable result. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers 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 wanted to look young,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate 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 slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Although research into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed face specialist, commenting anonymously, says he would avoid using fillers in a client because of the dangers they pose. “Many doctors avoid discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|