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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. Not for the usual reasons related to a house full of loud preteen kids, but because it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from south 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 result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor 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 indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to have a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts 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 face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the skin down with it.”

You risk operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and causes laxity in the skin – alongside the widespread use of slimming medications, cut-price medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of customer towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are now requesting to look like the optimal form of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the superficial layer, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they present. “A lot of surgeons don’t want to discussing this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – particularly when it began moving to different areas 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 exit the injectable hamster wheel. Two years later, she ended up selecting from a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|