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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the typical reasons associated with a house full of loud preteen children, but since it’s the first time she will showcase her recently altered face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not the way I appear,’” states the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via online 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

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to have a facelift in their twenties and thirties – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” says based in Kent face specialist 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 structural foundation of the face. And that is what ages us; that’s what becomes lax and drags the skin downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo 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.”

If injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. An esteemed face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|