‘My Eyes Were So Puffy I Was Unable to Even Open Them’

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical causes related to a house full of loud preteen children, but because it’s the initial occasion she will debut 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 the way I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of individuals electing to have a facelift in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and pulls the skin down with it.”

You endanger performing surgery on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

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

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the facial ligaments underneath, allowing surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a authentic-appearing and more durable result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. 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 “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use injectables in a patient because of the risks they pose. “Many doctors don’t want to discussing this, because the companies who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

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 local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option 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, 24 hours post she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|