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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual reasons related to a home packed of loud adolescent kids, but since it’s the initial occasion 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 the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Reports show an eight percent rise in facial lifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the techniques are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to reshape the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its ability to drain bodily fluid has been diminished.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would avoid using injectables in a patient because of the dangers they present. “A lot of surgeons don’t want to talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to exit the cycle of treatments. Two years later, she ended up choosing between a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in the country, she decided to add a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|