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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. It’s not due to the typical reasons related to a house full of clamorous adolescent kids, but since it’s the first time she will debut her new face to friends and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first 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: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to have a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we grow older. “Our faces are built a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and drags the skin downward with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling surgeons to restructure the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the whole facial structure as a unified block results in a authentic-appearing and more durable outcome. It additionally implies that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler harmed my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances completely disappear has long been a point of contention in the cosmetic field. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly fluid-filled because its capacity to remove bodily fluid has been diminished.” Though studies into the topic is early-stage, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would never use fillers in a client because of the risks they pose. “Many doctors avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state 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 list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|