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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. It’s not due to the typical reasons associated with a home packed of clamorous adolescent children, but since it’s the first time she will debut her new face to acquaintances and extended family. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ 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 individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and drags the skin downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use 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 development of new, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Statistics show an 8% increase in facelifts over the last year in the UK; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are asking now to look like the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling surgeons to restructure the face by moving the deeper tissue, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable outcome. It also means that the procedure is not just 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 receive many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late twenties, 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 in this situation currently.”

Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Although studies into the topic 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 avoid using injectables in a client because of the dangers they present. “A lot of doctors avoid discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions 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 began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. After 24 months, she ended up selecting from a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|