‘My Eyes Were So Swollen I Was Unable to Even Open Them’

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the usual reasons associated with a home packed of loud preteen children, but because it’s the first time she will debut her new face to friends and relatives. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband 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 explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people choosing to have a facelift in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic 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 personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin downward with it.”

You endanger 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 excessive use of injectable gels expands the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves lifting the superficial layer, the comprehensive lift loosens the underlying structures underneath, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking 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 cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

If dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly waterlogged because its ability to drain bodily fluid has been reduced.” Although studies into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use injectables in a client because of the risks they pose. “Many doctors avoid talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she ended up choosing between a list of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|