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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the typical reasons associated with a house full of clamorous adolescent kids, but since it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an minimally invasive 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 couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their 20s and 30s – well over a ten years prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this major operation. Reports show an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor 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.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and more durable result. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Although studies into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would never use fillers in a patient because of the dangers they pose. “Many surgeons avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|