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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons related to a home packed of clamorous preteen kids, but since it’s the first time she will showcase her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform 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 among a growing number of people choosing to undergo a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and leads to looseness in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing doctors to reshape the face by moving the underlying layers, 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 deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable result. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using injectable gels in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

If dermal fillers completely disappear has historically 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 lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat waterlogged because its ability to remove lymphatic fluid has been diminished.” 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 facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “A lot of doctors avoid talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|