‘My Eyes Were So Swollen I Couldn’t Even Open Them’

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual reasons associated with a home packed of loud preteen children, but since it’s the first time she will showcase her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding 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 structured a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is 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 conscientious surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts 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 35-55.

“Patients are asking now to look like the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied 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 did it because the filler ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly fluid-filled because its capacity to remove bodily fluid has been diminished.” Though studies into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a client because of the risks they pose. “Many doctors avoid discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue adding more – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|