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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a home packed of clamorous preteen kids, but since it’s the first time she will reveal her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are built a bit like layers of an onion,” explains based in Kent 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 structural foundation of the face. And that’s what ages us; that is what loosens and sags and pulls the skin down with it.”

You endanger operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the skin – combined with the common adoption of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“People are now requesting to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves elevating the SMAS, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable result. 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 “enhancement” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

If injectable substances completely disappear has long been a debated topic in the cosmetic field. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the reality that in a sense, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Though research into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a patient because of the risks they pose. “Many surgeons avoid talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift could be what she required to exit the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived alone in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|