‘My Eyes Were So Swollen I Was Unable to Even Unseal Them’

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual causes related to a house full of loud adolescent kids, but because it’s the first time she will showcase her new face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal 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 fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and pulls the skin downward with it.”

You endanger operating on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the common adoption of slimming medications, cut-price medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a new kind 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 revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using injectable gels in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the injectable ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

If injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the reality that to some extent, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Although research into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use injectables in a patient because of the risks they pose. “Many surgeons avoid discussing this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as it began moving to other parts 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 needed to finally step off the cycle of treatments. After 24 months, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|