‘My Eyes Were So Puffy I Couldn’t Even Open Them’

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the usual causes associated with a house full of clamorous preteen children, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I appear,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and drags the skin 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 stretches the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails elevating the superficial layer, the comprehensive lift releases the facial ligaments underneath, enabling doctors to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Although research into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would avoid using injectables in a client because of the risks they present. “Many surgeons avoid discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift could 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 the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|