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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical reasons related to a house full of clamorous adolescent kids, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” states the 30-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 held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen 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 jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to have a facelift in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a facelift, elevates the tissues in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and pulls the dermis downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice 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 – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Reports show an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“People are asking now to look like the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Lifting 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 not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never using it. If I didn’t have the injectable, 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. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned 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 filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift could be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Then he stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|