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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the typical causes associated with a home packed of clamorous preteen children, but since it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are built a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the filler ruined my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has long 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 ‘pillow face’ is additionally the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived alone in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|