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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual causes associated with a house full of loud adolescent kids, but because it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the skin down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the SMAS, the comprehensive lift releases the facial ligaments underneath, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the filler harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research announced. An esteemed face specialist, speaking anonymously, mentioned he would avoid using injectables in a client because of the risks they present. “A lot of surgeons avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facial lift was the right solution for the laxity she was experiencing in her face. She booked 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 lip lift. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|