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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the usual causes related to a house full of clamorous adolescent kids, but since it’s the first time she will showcase her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” states the 30-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the result of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and drags the dermis down with it.”

You endanger operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the dermis – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed operative methods are attracting a new kind of patient towards this invasive surgery. Reports show an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat waterlogged because its ability to remove bodily fluid has been reduced.” Although studies into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use fillers in a client because of the risks they present. “Many doctors avoid discussing this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|