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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the usual reasons associated with a home packed of loud preteen kids, but because it’s the initial occasion she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, well, a little startling – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of people electing to undergo a facelift in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and drags the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing doctors to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” explains 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 entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its capacity to drain lymphatic fluid has been diminished.” Though research into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they pose. “Many surgeons don’t want to talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. After 24 months, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|