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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the typical causes related to a house full of clamorous adolescent kids, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds asking for facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant 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 personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Our faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and drags the skin downward with it.”

You endanger performing surgery on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and causes looseness in the skin – combined with the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Statistics show an eight percent rise in facelifts over the past 12 months in the UK; while a survey found that the portion of younger facelift patients is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to look like the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails lifting the superficial layer, the comprehensive lift releases the underlying structures underneath, allowing doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have indicated that they seldom completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the risks they pose. “Many doctors avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she needed to continue adding more – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift might be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a list of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|