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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the usual reasons associated with a home packed of clamorous adolescent children, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people electing to undergo a facelift in their 20s and 30s – significantly before a ten years prior to typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the tissues in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and drags the skin downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the skin – combined with the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the superficial layer, the deep plane facelift releases the underlying structures underneath, allowing doctors to reshape the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” 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 hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant 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 underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

If injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Though research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and further research initiated. An esteemed face specialist, commenting anonymously, mentioned he would avoid using fillers in a patient because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she required to finally step off the cycle of treatments. After 24 months, she ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|