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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the usual reasons related to a house full of loud adolescent children, but because it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed 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 video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are now requesting to look like the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” 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 undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets slightly waterlogged because its ability to drain bodily fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use fillers in a patient because of the risks they present. “Many surgeons avoid talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|