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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. Not for the typical causes associated with a home packed of loud preteen children, but because it’s the first time she will showcase her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I appear,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals electing to undergo a facelift in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are built a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques 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 survey revealed that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But years of using injectable gels in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

If dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face becomes 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 further research initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they present. “Many doctors don’t want to discussing this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d touched down solo in Turkey, 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 extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|