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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the usual causes related to a home packed of loud adolescent children, but since it’s the first time she will showcase her new face to acquaintances and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a facelift in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we grow older. “Our faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that is what loosens and sags and drags the skin downward with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is increasing, with one-third of procedures 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. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the deep plane facelift releases the facial ligaments underneath, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting result. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But years of using injectable gels in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Although studies into the area is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the dangers they pose. “A lot of surgeons don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift could be what she required to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d touched down solo in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|