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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the usual causes related to a house full of loud adolescent kids, but because it’s the first time she will debut her new face to acquaintances and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – 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, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to have a facelift in their 20s and 30s – well over a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis downward with it.”

You endanger operating on people that have deeper issues. 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 dermal fillers stretches the face and leads to looseness in the skin – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a new kind of customer towards this invasive surgery. Reports show an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional facelift entails elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and more durable result. It additionally implies that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly waterlogged because its ability to remove bodily fluid has been diminished.” Although research into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would never use fillers in a patient because of the dangers they present. “A lot of doctors avoid discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|