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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the typical reasons related to a house full of clamorous adolescent kids, but since it’s the first time she will showcase her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” says the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the result of six cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the initial 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: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are built a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the skin downward with it.”

You endanger performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a new kind of customer towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the methods are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” 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 underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that in a sense, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift 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 day before her surgery, 24 hours post she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|