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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous preteen kids, but because it’s the initial occasion she will debut her new face to friends and relatives. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” states the 30-year-old property agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are asking now to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional 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 look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using injectable gels in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

If dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its capacity to drain bodily fluid has been diminished.” Although studies into the area is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a client because of the risks they pose. “A lot of doctors don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift could be what she required to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|