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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of loud adolescent kids, but because it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m okay, 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 people choosing to undergo a facelift in their 20s and 30s – significantly before a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the UK; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to look like the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable result. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Research have indicated that they seldom fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research announced. An esteemed face specialist, commenting on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “Many doctors avoid talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|