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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of clamorous preteen kids, but since it’s the first time she will debut her new face to friends and relatives. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are structured a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls the dermis down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and causes laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and more durable result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is additionally the reality that to some extent, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been diminished.” Though research into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would never use fillers in a client because of the risks they present. “A lot of surgeons avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|