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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the typical reasons associated with a home packed of clamorous adolescent children, but since it’s the initial occasion she will showcase her new face to friends and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I look,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are built a bit like layers of an onion,” 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 facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the skin down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, low-cost surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a study 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 look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the superficial layer, the deep plane facelift releases the underlying structures underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. 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 contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though research into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, speaking anonymously, mentioned he would never use injectables in a patient because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon 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 choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended 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 neck lift. The eve of her surgery, one day after 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 think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|