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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the usual reasons related to a home packed of loud preteen children, but because it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though secured 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 endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of people choosing to have a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, 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 head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, 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 ages us; that is what becomes lax and drags the skin 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 affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the dermis – combined with the widespread use of slimming medications, cut-price surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a new kind of patient towards this major operation. Reports show an eight percent rise in facial lifts over the last year in the UK; while a survey found that the portion of younger facelift patients is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable ruined my face. I regret ever 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. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate 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 waterlogged because its ability to remove bodily fluid has been diminished.” Though research into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they pose. “Many doctors don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with 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 – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – 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 arranged a brow lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d touched down alone in Turkey, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|