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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the typical reasons related to a house full of loud preteen children, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – 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 Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people choosing to have a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments 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. “Dermis and adipose on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the skin down with it.”

You endanger operating on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the UK; while a survey found that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

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

If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though studies into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and additional studies initiated. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a client because of the risks they present. “Many surgeons don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing court orders after expressing worries.

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 different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she needed to exit the injectable hamster wheel. After 24 months, she found herself choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d touched down alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|