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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the usual reasons associated with a house full of loud adolescent children, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and pulls the dermis downward with it.”

You risk operating on people that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the skin – combined with the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing doctors to reshape the face by moving the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Lifting 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 not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a client because of the risks they pose. “Many doctors avoid discussing this, because the manufacturers who make injectables can be quite forceful.” 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 had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she required to exit the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the right solution 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 operation, one day after she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|