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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the typical causes associated with a house full of clamorous preteen children, but since it’s the initial occasion she will showcase her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the dermis down with it.”

You endanger operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” 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 think I would be in this situation currently.”

If injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face gets slightly waterlogged because its capacity to remove bodily fluid has been reduced.” Although research into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage 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 patient because of the dangers they pose. “Many doctors don’t want to discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – 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 required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended 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, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|