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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of clamorous preteen kids, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people choosing to undergo a facelift in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting 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 procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Our faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the SMAS. Consider 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 dermis downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to appear as 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 fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But long-term using injectable gels 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 wanted to look youthful,” she says. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use fillers in a client because of the dangers they pose. “Many surgeons don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift could be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the correct option for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Then he said, ‘We will elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|