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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a home packed of loud preteen children, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

Her appearance is, well, a little startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the result of six cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the initial 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: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people electing to undergo a facelift in their twenties and thirties – significantly before a ten years before most doctors’ usual candidate age of forty to sixty. (Although 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,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as 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,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by repositioning the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat waterlogged because its capacity to drain bodily fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the risks they present. “Many doctors don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d touched down alone in the country, she decided to add a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|