‘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 house full of clamorous preteen kids, but because it’s the first time she will debut her recently altered 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 property agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that start to sag as we age. “Our faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; 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 follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block results in a authentic-appearing and more durable outcome. It also means that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a patient because of the dangers they pose. “Many surgeons avoid talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she found herself choosing between a list of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift 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. “Then he said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|