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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. Not for the typical causes associated with a house full of clamorous adolescent children, but since it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw 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 house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the skin downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a different type of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the injectable harmed my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has long been a debated topic in the cosmetic field. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the reality that to some extent, the face gets somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Although studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a client because of the risks they present. “Many doctors don’t want to discussing this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as 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 face and neck lift could be what she needed to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|