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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual reasons associated with a home packed of clamorous preteen children, but because it’s the first time she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, well, a little startling – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people choosing to have a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the dermis down with it.”

You risk operating on individuals 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 dermal fillers stretches the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Statistics show an eight percent rise in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are asking now to look like the best version 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 Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the fact that to some extent, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the risks they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to exit the cycle of treatments. Two years later, she found herself choosing between a selection 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 facelift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d touched down alone in the country, she opted to include a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|