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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a house full of loud preteen children, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people electing to have a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and drags the dermis down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Reports show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are following,” says 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 entails elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled look sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street 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 single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But years of using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking anonymously, says he would never use fillers in a client because of the dangers they present. “Many surgeons don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she required to finally step off the cycle of treatments. After 24 months, she ended up choosing between a selection of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d touched down alone in the country, she decided to add a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|