‘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 reasons associated with a house full of clamorous adolescent kids, but because it’s the initial occasion she will debut her recently altered face to acquaintances and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, 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 explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of people electing to undergo a facelift in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Human faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and drags the skin down with it.”

You endanger 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, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the skin – combined with the widespread use of slimming medications, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the SMAS, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its capacity to remove bodily fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would never use fillers in a patient because of the risks they present. “A lot of doctors avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

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 just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she required to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|