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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a house full of loud preteen children, but since it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up 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 online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked 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 before most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict 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 very significant surgery, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and pulls the skin downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to looseness in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports show an eight percent rise in facial lifts over the past 12 months in the UK; while a study found that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and obviously the methods are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis 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 secondary element.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers 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 desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “A lot of doctors don’t want to discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. After 24 months, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|