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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the typical reasons associated with a home packed of loud adolescent children, but because it’s the first time she will showcase her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” states the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Statistics show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although studies into the topic is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, speaking anonymously, mentioned he would never use fillers in a client because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the manufacturers who make filler 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 using injectables, she believed she had to keep adding more – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to exit the injectable hamster wheel. After 24 months, she ended up choosing between a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution 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, one day after she’d arrived alone in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate 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 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|