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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the usual reasons related to a house full of clamorous preteen children, but since it’s the first time she will debut her new face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Human faces are built a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and drags the skin down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and more durable outcome. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests 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 age of 30. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use injectables in a patient because of the risks they pose. “Many doctors avoid talk about this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

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 the state suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her 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 jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in the country, she decided to add a lip lift. “Then he said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|