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

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. Not for the typical causes related to a house full of clamorous adolescent kids, but because it’s the initial occasion she will reveal her new face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” states the 30-year-old property agent from south Florida.

Her appearance is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the skin downward with it.”

You endanger performing surgery on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Statistics 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 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and more durable result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers 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 wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘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 reduced.” Though studies into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a client because of the dangers they pose. “Many doctors avoid discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she found herself selecting from a list of suggested accommodations in the city, texted 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 surgeon recommended that a facelift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|