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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the typical reasons related to a home packed of clamorous preteen kids, but because it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of people electing to have a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments 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. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and drags the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat waterlogged because its ability to remove lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would avoid using injectables in a client because of the dangers they present. “A lot of surgeons don’t want to discussing this, because the companies who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she ended up choosing between 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 – commonly called blepharoplasty – but her doctor recommended that a facial lift was the right solution for the looseness 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 touched down alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|