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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the typical causes related to a home packed of clamorous preteen children, but because it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a facelift in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS 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 endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the SMAS, the deep plane facelift releases the facial ligaments underneath, enabling surgeons to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched look occasionally caused by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable outcome. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would never use injectables in a client because of the risks they present. “A lot of surgeons don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after expressing worries.

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 local plastic surgeon in the state suggested that a face and neck lift could be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d touched down alone in Turkey, she opted to include a lip lift. “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.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|