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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the usual causes related to a house full of loud preteen children, but because it’s the first time she will debut her new face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, 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 rising count of individuals choosing to have a facelift in their 20s and 30s – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the skin down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the SMAS, the deep plane facelift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

If injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although research into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, commenting anonymously, mentioned he would never use injectables in a patient because of the dangers they present. “A lot of doctors avoid talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I think 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 half-day surgery, including a three-day|