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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual causes related to a house full of loud adolescent children, but because it’s the initial occasion she will debut her new face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Babe, I’m fine, 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 – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat 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’s what causes aging; that is what becomes lax and pulls the dermis down with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the portion of younger facelift patients is growing, with 32% of facelifts now performed on patients 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 promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and more durable result. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and further research announced. An esteemed face specialist, commenting anonymously, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of surgeons avoid 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 legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to lift 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 surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|