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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the usual reasons associated with a house full of loud adolescent children, but since it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not how I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen and unnaturally tightened, 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, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals electing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that is what becomes lax and pulls the skin downward with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and causes looseness in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are now requesting to look like the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails lifting the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London 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 whole facial structure 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 rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its capacity to remove bodily fluid has been diminished.” Although research into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “Many doctors don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|