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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous adolescent children, but since it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My spouse teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals electing to have a facelift in their twenties and thirties – well over a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a facelift, elevates the ligaments in the face that start to sag as we age. “Our faces are built a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and drags the skin downward with it.”

You risk operating on people that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a new kind of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It additionally implies that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the injectable ruined my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face becomes somewhat waterlogged because its capacity to remove bodily fluid has been reduced.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a patient because of the dangers they pose. “A lot of surgeons don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – 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 face and neck lift could be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|