‘I Couldn’t Even Unseal My Eyes. That’s How Swollen I Was’

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a home packed of clamorous adolescent kids, but because it’s the initial occasion she will reveal 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 look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what becomes lax and drags the skin downward with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the skin – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the percentage of younger facelift patients is growing, 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 following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the SMAS, the comprehensive lift loosens the facial ligaments beneath it, 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 underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though studies into the topic is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and further research announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they present. “Many doctors avoid talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d arrived alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|