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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes associated with a house full of clamorous preteen kids, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first 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 had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and drags the dermis down with it.”

You endanger performing surgery 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 dermal fillers expands the face and causes looseness in the skin – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But years of 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 young,” 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 think I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Although studies into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would avoid using injectables in a patient because of the risks they present. “A lot of doctors don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep 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 exit the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|