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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the typical reasons associated with a house full of clamorous adolescent children, but since it’s the initial occasion she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop 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 stratum of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and drags the skin downward with it.”

You endanger operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the SMAS, the deep plane facelift loosens the underlying structures beneath it, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended 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 twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to drain bodily fluid has been reduced.” Although research into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies announced. An esteemed facial plastic surgeon, speaking anonymously, says he would never use fillers in a patient because of the risks they present. “Many doctors don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to exit the injectable hamster wheel. After 24 months, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|