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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the usual causes associated with a home packed of clamorous adolescent kids, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the result of six cosmetic procedures, including an endoscopic mid-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 couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic 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 choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that is 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 pursue

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails elevating the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Elevating the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler harmed my face. I regret ever using it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is also the fact that to some extent, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a patient because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she needed to exit the cycle of treatments. Two years later, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift was the correct option 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 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 believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|