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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. It’s not due to the usual causes related to a house full of clamorous preteen children, but because it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-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 wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to have a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are built a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Consider 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 downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes looseness in the dermis – combined with the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this major operation. Reports show an eight percent rise in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the skin 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 skin comes with it as a passenger.” Elevating the whole facial structure as a unified block 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 youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and additional studies 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 risks they present. “A lot of doctors avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will sculpt 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|