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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual reasons related to a home packed of loud preteen kids, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the result of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

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 little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

You risk operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the underlying structures underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Elevating 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 revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face gets somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Although studies into the area is early-stage, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies initiated. An esteemed face specialist, commenting anonymously, mentioned he would avoid using fillers in a patient because of the dangers they pose. “A lot of surgeons avoid talk about this, because the companies who produce filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift might 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 surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|