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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a house full of clamorous preteen children, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of half a dozen 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 first time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via video call from her house. “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 among a rising count of people electing to undergo a facelift in their 20s and 30s – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a facelift, elevates the tissues in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and drags the dermis downward with it.”

You endanger operating on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the development of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on individuals 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 operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, enabling surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though research into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed face specialist, commenting anonymously, mentioned he would never use injectables in a patient because of the dangers they pose. “A lot of doctors avoid talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – 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 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, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in the country, she decided to add a mouth enhancement. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|