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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes related to a home packed of clamorous preteen kids, but because it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ typical patient age range of 40 to 60. (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 based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Our faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as 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 operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of new, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to look like the best version of themselves and obviously the methods are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late twenties, 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 regret ever done it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Though research into the topic is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “Many surgeons avoid discussing this, because the companies who make filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|