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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of clamorous preteen kids, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to have a facelift in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as 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 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 moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to laxity in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

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

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the injectable ruined my face. I wish I had never done 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 historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a patient because of the risks they pose. “Many doctors don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift could be what she required to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a selection of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in the country, she decided to add a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we extract 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|