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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the typical reasons associated with a home packed of clamorous adolescent children, but because it’s the initial occasion she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to 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 attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people electing to have a facelift in their 20s and 30s – well over a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are built a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and drags the dermis down with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the comprehensive lift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched 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 plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It also means that the surgery is not just being used for the express purpose 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.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has long been a debated topic in the cosmetic field. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its capacity to remove bodily fluid has been reduced.” Though studies into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies announced. An esteemed face specialist, speaking anonymously, mentioned he would avoid using fillers in a client because of the dangers they present. “A lot of surgeons avoid talk about this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|