‘My Eyes Were So Swollen I Was Unable to Even Unseal Them’

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes associated with a home packed of clamorous preteen kids, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and drags the skin down with it.”

You risk performing surgery 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, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit results in a authentic-appearing and longer-lasting result. It additionally implies that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of 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 desired to appear young,” she clarifies. “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 where I’m at right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face gets somewhat waterlogged because its capacity to drain bodily fluid has been diminished.” Though research into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been released, and additional studies initiated. An esteemed face specialist, commenting anonymously, mentioned he would never use fillers in a client because of the risks they pose. “Many doctors avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she ended up selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|