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

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. Not for the usual causes related to a home packed of loud adolescent children, but because it’s the initial occasion she will showcase her new face to friends and extended family. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial 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: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that begin to droop as we grow older. “Our faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors don’t want to discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|