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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. Not for the usual causes related to a house full of loud preteen children, but since it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of people choosing to have a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

You endanger operating on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of customer towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“People are asking now to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments underneath, allowing doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” 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 surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though research into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using fillers in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. Two years later, she ended up selecting from a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|