‘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 because it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen 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 six aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the initial 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 needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to have a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the skin 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 underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable result. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting 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 undergo this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly fluid-filled because its ability to drain bodily fluid has been reduced.” Though studies into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been released, and additional studies initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the dangers they pose. “Many doctors avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift could be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in the city, 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 recommended 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 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 believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|