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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the typical causes associated with a house full of loud preteen children, but because it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are structured a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and obviously the methods are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests 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 long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though studies into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a patient because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will 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 including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|