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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the typical reasons related to a home packed of loud preteen children, but because it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband 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 online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the skin down with it.”

You risk operating on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of customer towards this major operation. Reports show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the underlying structures underneath, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable result. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

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 “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly fluid-filled because its capacity to remove bodily fluid has been diminished.” Though research into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use injectables in a client because of the dangers they pose. “A lot of surgeons don’t want to discussing this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she found herself selecting from a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|