‘My Eyes Were So Puffy I Was Unable to Even Open Them’

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. It’s not due to the typical reasons associated with a house full of clamorous adolescent kids, but since it’s the first time she will reveal her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of people electing to undergo a facelift in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and drags the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

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 effort at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though research into the topic is early-stage, 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, mentioned he would never use fillers in a patient because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep adding more – particularly when it began moving to different areas 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 needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|