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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. It’s not due to the usual reasons related to a house full of loud adolescent kids, but since it’s the first time she will showcase her new face to acquaintances and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people electing to have a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states 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 bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A facelift, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Human faces are built a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the dermis down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the UK; while a study found that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a single unit results in a authentic-appearing and more durable result. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although studies into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the dangers they pose. “Many surgeons avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep 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 facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she ended up choosing between a selection of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facial lift 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 day before her surgery, one day after she’d arrived solo in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|