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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the typical causes associated with a house full of loud adolescent children, but because it’s the initial occasion she will reveal her new face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the dermis down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a survey found that the portion of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, 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 passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort 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 says. “I did it because the filler ruined 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 currently.”

Whether injectable substances completely disappear has long been a debated topic in the cosmetic field. “Research have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face becomes slightly fluid-filled because its ability to drain bodily fluid has been diminished.” Though studies into the topic is preliminary, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a client because of the risks they pose. “A lot of surgeons avoid discussing this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|