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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the usual reasons associated with a home packed of clamorous adolescent children, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people electing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human faces are built a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the superficial layer, the comprehensive lift loosens the underlying structures underneath, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a authentic-appearing and longer-lasting result. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Research have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its ability to remove bodily fluid has been reduced.” Although studies into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, 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 had to keep adding more – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she required to finally step off the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|