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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a house full of loud preteen children, but because it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a facelift in their twenties and thirties – 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 genetics, not years.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, 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 causes aging; that’s what becomes lax and pulls the skin downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Reports show an 8% increase in facial lifts over the last year in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are now requesting to appear as the best version of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that in a sense, the face gets somewhat fluid-filled because its ability to remove bodily fluid has been diminished.” Although research into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and additional studies announced. An esteemed face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the dangers they present. “A lot of doctors don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|