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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the usual reasons associated with a house full of loud adolescent children, but because it’s the initial occasion she will debut her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of people electing to have a facelift in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see 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 start to sag as we grow older. “Our faces are built a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and pulls the dermis down with it.”

You risk operating on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“People are now requesting to look like the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling surgeons to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – 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 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that in a sense, the face gets slightly waterlogged because its capacity to remove lymphatic fluid has been diminished.” Though studies into the area is preliminary, warnings on injectables’ potential impact on the body’s drainage have been released, and further research announced. An esteemed face specialist, commenting on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “Many doctors avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift might be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d touched down alone in the country, she decided to add a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|