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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the usual causes related to a house full of clamorous adolescent 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 everyone as they arrive, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic 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 see people opting for it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and pulls the dermis down with it.”

You endanger 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 dermal fillers stretches the face and causes looseness in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Reports show an eight percent rise in facial lifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though research into the topic is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a client because of the risks they present. “A lot of doctors don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when 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 could be what she required to exit the injectable hamster wheel. Two years later, she ended up selecting from a selection of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|