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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the typical reasons related to a home packed of loud adolescent children, but because it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed 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 video call from her home. “I had to tell 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 among a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and pulls the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the skin – combined with the common adoption of slimming medications, low-cost surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are attracting a different type of patient towards this major operation. Reports indicate an 8% increase in facelifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the SMAS, the comprehensive lift loosens the facial ligaments underneath, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” 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 ruined my face. I wish I had never using it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the fact that to some extent, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been reduced.” Though studies into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a client because of the risks they present. “Many doctors avoid discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Then he said, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|