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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a home packed of loud adolescent kids, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

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

Deep Plane Technique

Where a more traditional facelift entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, allowing doctors to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would never use fillers in a patient because of the dangers they present. “Many doctors avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|