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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the typical causes related to a house full of loud adolescent kids, but since it’s the first time she will showcase her recently altered face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of people choosing to have a facelift in their twenties and thirties – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Human faces are structured 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 connective tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and pulls the skin downward with it.”

You endanger performing surgery on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facelifts over the last year in the UK; while a study found that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a secondary element.” Lifting the whole facial structure as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the filler harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that in a sense, the face gets somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Though research into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been released, and further research announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a client because of the risks they pose. “Many surgeons don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facelift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|