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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the usual reasons related to a house full of clamorous adolescent kids, but because it’s the initial occasion she will reveal her new face to friends and extended family. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a facelift in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive 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 is what becomes lax and drags the skin downward with it.”

You risk operating on individuals that have underlying problems. 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 laxity in the skin – alongside the common adoption of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are asking now to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting result. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

If dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its capacity to remove bodily fluid has been reduced.” Although studies into the area is early-stage, warnings on injectables’ possible effects on the body’s drainage have been released, and further research announced. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using fillers in a client because of the risks they pose. “Many surgeons avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|