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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of clamorous preteen kids, but since it’s the initial occasion she will showcase her recently altered face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up 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 video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis down with it.”

You endanger operating on people that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Reports indicate an 8% increase in facelifts over the last year in the UK; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves lifting the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to reshape the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block 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 youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly fluid-filled because its capacity to remove bodily fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they pose. “A lot of doctors avoid talk about this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended 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 neck lift. The eve of her operation, 24 hours post she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|