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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of loud adolescent children, but because it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not the way I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a little startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – appearance is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to have a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I see 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. “Our faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and drags the skin downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to looseness in the skin – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block results in a authentic-appearing and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the fact that to some extent, the face gets somewhat waterlogged because its ability to remove bodily fluid has been diminished.” Although research into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would avoid using fillers in a client because of the risks they present. “Many surgeons don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|