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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the typical reasons associated with a home packed of loud preteen kids, but because it’s the first time she will reveal her recently altered 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 30-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, 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 explains to 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 jumped me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are built a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the dermis down with it.”

You risk performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Reports show an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are asking now to appear as the optimal form of themselves and naturally the methods are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late twenties, 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 using it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown 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 ‘pillow face’ is additionally the reality that in a sense, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Although studies into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use fillers in a client because of the risks they present. “A lot of doctors don’t want to talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. Two years later, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – 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 arranged a brow lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d touched down solo in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|