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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the typical causes related to a house full of clamorous adolescent kids, but because it’s the first time she will showcase her new face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how 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 hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a ten years prior to most doctors’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Human faces are built a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and pulls the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, cut-price medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been reduced.” Although studies into the area is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the dangers they present. “Many doctors 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 being landed with legal actions after expressing worries.

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 nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d touched down alone in the country, 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 extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|