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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual reasons associated with a house full of loud preteen children, but since it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” states the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are built a bit like layers of an onion,” explains 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. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the dermis downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the fact that in a sense, the face gets somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a patient because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in the country, 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 extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|