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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the usual reasons related to a house full of loud adolescent kids, but because it’s the initial occasion she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open 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 appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the skin downward with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are driving a new kind of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails elevating the SMAS, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting outcome. It additionally implies that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” 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 becomes slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Although research into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a patient 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 pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it began moving 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 cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived alone in Turkey, 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 cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|