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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. It’s not due to the typical causes related to a home packed of clamorous preteen kids, but because it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of individuals choosing to have a facelift in their 20s and 30s – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” explains based in Kent face specialist 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 soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are attracting a different type of customer towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” 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 primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the filler ruined my face. I wish I had never using it. If I had avoided the filler, I don’t think I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they move 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 reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and additional studies announced. An esteemed face specialist, commenting anonymously, mentioned he would never use fillers in a client because of the dangers they present. “A lot of surgeons don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|