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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical reasons related to a house full of loud adolescent kids, but since it’s the first time she will debut her new face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of people electing to undergo a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

You endanger operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the dermis – alongside the widespread use of slimming medications, cut-price surgical travel, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift releases the underlying structures underneath, enabling surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – 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,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Although studies into the area is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using fillers in a client because of the dangers they present. “A lot of doctors avoid discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift could be what she needed to exit the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a cheek lift 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. “Then he said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|