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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the usual causes associated with a house full of loud preteen children, but since it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and pulls the dermis downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It additionally implies that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be where I’m at right now.”

If injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a patient because of the dangers they present. “Many doctors avoid talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|