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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual reasons related to a house full of loud adolescent kids, but because it’s the first time she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old property agent from Southern Florida.

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

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to have a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the skin downward with it.”

You risk operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the skin – alongside the widespread use of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the UK; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged 35-55.

“People are asking now to look like the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and more durable result. It also means that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

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 effort at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face becomes somewhat waterlogged because its capacity to remove bodily fluid has been reduced.” Though studies into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, speaking anonymously, mentioned he would never use fillers in a patient because of the risks they pose. “Many surgeons avoid talk about this, because the companies who make 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, once she started injecting filler, she believed she had to keep replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|