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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons related to a home packed of clamorous preteen children, but because it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how 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 jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a facelift in their 20s and 30s – well over a decade prior to most doctors’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis down with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised 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 comprehensive lift releases the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive 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 long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be where I’m at 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 lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though research into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they pose. “Many surgeons don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|