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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons related to a home packed of loud adolescent children, but since it’s the first time she will debut her recently altered face to friends and extended family. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals electing to have a facelift in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that is what loosens and sags and pulls the skin down with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and leads to looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are asking now to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

If injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its ability to drain bodily fluid has been reduced.” Though studies into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed face specialist, speaking anonymously, says he would never use fillers in a client because of the dangers they pose. “A lot of 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.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|