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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the usual causes related to a house full of loud adolescent children, but because it’s the first time she will debut her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals choosing to have a facelift in their twenties and thirties – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

You risk operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to restructure 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 deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be in this situation right now.”

If injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Research have shown that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they pose. “A lot of doctors don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facial lift was the correct option 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 operation, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|