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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the typical causes related to a house full of loud adolescent children, but since it’s the first time she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, 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 aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people electing to have a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework 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 individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to looseness in the skin – combined with the common adoption of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Statistics show 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 individuals aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to restructure the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, 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. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face gets somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “A lot of doctors don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove 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|