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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a home packed of clamorous adolescent children, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a facelift, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a new kind of customer towards this major operation. Reports show an 8% increase in facelifts over the last year in the UK; while a study found that the portion of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are asking now to look like the best version of themselves and naturally the methods are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional facelift entails elevating the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to restructure the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused 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 specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients 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 attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Although studies into the topic is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a client because of the risks they pose. “A lot of surgeons avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We will lift the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|