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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the typical causes related to a house full of clamorous adolescent kids, but since it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, 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 indicates swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals choosing 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. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have 28-year-olds requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the skin down with it.”

You risk operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are now requesting to look like the best version of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift releases the underlying structures underneath, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis 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 deeper tissue that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing 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 cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries 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 years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘pillow face’ is additionally the fact that to some extent, the face becomes slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Although studies into the area is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a client because of the risks they present. “Many doctors don’t want to discussing this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift could be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|