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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the usual reasons associated with a home packed of clamorous preteen kids, but because it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy 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 jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to have a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and pulls the skin down with it.”

You endanger operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to looseness in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension 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 underlying layers that is adjusted. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting result. 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 “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies announced. One highly regarded face specialist, speaking on the condition of anonymity, says he would never use injectables in a patient because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels 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 blepharoplasty – but her doctor advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|