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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the usual causes associated with a house full of clamorous adolescent kids, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people electing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed operative methods are driving a new kind of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Although research into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking 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 make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state 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 the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|