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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the typical reasons associated with a house full of clamorous adolescent kids, but because it’s the initial occasion she will debut her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse 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 tells me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant 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 lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and pulls the skin down with it.”

You endanger operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and causes looseness in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the underlying structures underneath, allowing doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, 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 reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Research have shown that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Though studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded face specialist, commenting anonymously, mentioned he would avoid using injectables in a client because of the risks they present. “A lot of surgeons don’t want to 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 expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue 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 suggested that a face and neck lift could be what she needed to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|