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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the usual causes related to a home packed of loud adolescent children, but since it’s the first time she will reveal her new face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “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, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to laxity in the skin – combined with the common adoption of slimming medications, cut-price medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study found 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 optimal form of themselves and obviously the techniques are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” 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 procedure is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Though studies into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a client because of the dangers they pose. “A lot of surgeons avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it began moving to other parts 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 required to exit the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|