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

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. Not for the usual reasons related to a house full of clamorous preteen kids, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I appear,’” states the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via online 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

According to cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the skin downward with it.”

You endanger operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to looseness in the skin – combined with the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the UK; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using fillers in a client because of the dangers they pose. “Many doctors avoid talk about this, because the companies who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate 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 procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|