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

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. It’s not due to the typical causes associated with a home packed of loud adolescent children, but since it’s the initial occasion she will reveal her new face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a decade before typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the tissues in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the dermis down with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a study revealed 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 best version of themselves and naturally the methods are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they present. “Many surgeons avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

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 the state suggested that a face and neck lift could be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down solo in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|