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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. It’s not due to the usual reasons associated with a house full of loud adolescent kids, but since it’s the first time she will showcase her recently altered face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of people electing to undergo a facelift in their 20s and 30s – well over a decade before most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the skin downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed surgical techniques are attracting a different type of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing stress on the skin 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 deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached 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 done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have indicated that they seldom fully dissipate,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed face specialist, commenting anonymously, mentioned he would never use fillers in a patient because of the risks they present. “Many doctors don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, including a three-day|