‘My Eyes Were So Puffy I Was Unable to Even Unseal Them’

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous preteen kids, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to undergo a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address genetics, 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 facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we grow older. “Our faces are built a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls the skin downward with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the UK; while a study found that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the facial ligaments underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a unified block results in a authentic-appearing and more durable result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do 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 filler, I don’t believe I would be where I’m at currently.”

Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, commenting anonymously, says he would never use injectables in a client because of the risks they present. “A lot of surgeons avoid discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. Two years later, she ended up choosing between a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|