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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a home packed of clamorous preteen children, but because it’s the first time she will showcase her recently altered face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals electing to undergo a facelift in their twenties and thirties – well over a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of new, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block results in 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 rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face gets somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Though research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a client because of the risks they pose. “A lot of surgeons don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|