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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual causes associated with a house full of loud preteen children, but because it’s the first time she will debut her recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up 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 house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that is what ages us; that is what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

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

Deep Plane Technique

While a conventional facelift entails lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We avoid placing 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 repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I did 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 right now.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the fact that in a sense, the face gets slightly waterlogged because its ability to remove bodily fluid has been diminished.” Although research into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the risks they present. “Many surgeons don’t want to discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the correct option for the looseness 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 solo in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract 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 six-hour surgery, plus a three-day|