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

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. It’s not due to the typical causes related to a house full of loud adolescent kids, but since it’s the first time she will debut her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a facelift in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” says based in London cosmetic 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 individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider 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 deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and obviously the methods are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to restructure the face by moving the deeper tissue, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “Many surgeons don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|