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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a house full of loud adolescent children, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Our faces are structured a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; 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 ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the advancement of new, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Reports indicate an eight percent rise in facial lifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling doctors to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its ability to drain bodily fluid has been diminished.” Although research into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “Many surgeons don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|