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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. Not for the usual causes related to a home packed of clamorous preteen children, but because it’s the initial occasion she will debut her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the result of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on 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 Rhytidectomy Surgery

A facelift, also known as a facelift, elevates 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 top, then a layer of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the UK; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” 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.”

If dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been reduced.” Although studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned 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 companies who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|