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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons related to a house full of loud adolescent children, but because it’s the initial occasion she will showcase her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to have a facelift in their 20s and 30s – well over a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are built a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that is what becomes lax and drags the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” 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 in this situation right now.”

If dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Research 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 term ‘pillow face’ is also the fact that in a sense, the face gets slightly waterlogged because its ability to remove bodily fluid has been diminished.” Though research into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, speaking anonymously, mentioned he would avoid using fillers in a patient because of the risks they present. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was just 28 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. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe 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, including a three-day|