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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. Not for the usual causes associated with a home packed of loud adolescent kids, but since it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the result of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals electing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a bit 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 structural foundation of the face. And that is what causes aging; that’s what becomes lax and drags the dermis downward with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics indicate an eight percent rise in facelifts over the last year in the UK; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves elevating the superficial layer, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is additionally the fact that in a sense, the face becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Although studies into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, commenting anonymously, mentioned he would never use injectables in a client because of the dangers they present. “Many surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|