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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the typical reasons related to a house full of loud adolescent children, but because it’s the first time she will debut her recently altered face to acquaintances and extended family. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of people choosing to undergo a facelift in their twenties and thirties – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and causes looseness in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, enabling doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent 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 where I’m at currently.”

Whether injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Though research into the area is early-stage, warnings on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, speaking anonymously, mentioned he would avoid using injectables in a patient because of the dangers they pose. “Many doctors don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|