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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the typical causes related to a house full of clamorous adolescent children, but because it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed 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 home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and drags the skin down with it.”

You risk operating on people that have underlying problems. 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 expands the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the underlying structures underneath, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

Whether injectable substances completely disappear has long been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although research into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed face specialist, speaking anonymously, mentioned he would avoid using fillers in a patient because of the risks they present. “A lot of surgeons don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d touched down alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|