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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the typical reasons related to a home packed of clamorous preteen kids, but because it’s the initial occasion she will debut her recently altered face to acquaintances and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a rising count of people electing to undergo a facelift in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags 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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the underlying structures underneath, enabling surgeons to restructure the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face becomes slightly fluid-filled because its capacity to remove bodily fluid has been diminished.” Though studies into the area is early-stage, warnings on injectables’ possible effects on the body’s drainage have been released, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use injectables in a client because of the dangers they present. “Many doctors avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if 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 the state proposed 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 list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|