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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. Not for the usual causes associated with a home packed of clamorous adolescent kids, but because it’s the first time she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, including an endoscopic mid-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 open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a facelift in their twenties and thirties – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the skin downward with it.”

You endanger operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling surgeons to reshape the face by moving the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and more durable result. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its ability to remove bodily fluid has been diminished.” Although research into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and additional studies announced. One highly regarded face specialist, speaking anonymously, says he would avoid using fillers in a client because of the risks they present. “Many doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|