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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the typical reasons related to a house full of clamorous preteen children, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the initial 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 needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of people choosing to have a facelift in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in 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 rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the last year in the UK; while a study revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the fact that in a sense, the face gets somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though studies into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would never use injectables in a patient because of the risks they present. “A lot of surgeons don’t want to discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|