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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. Not for the typical causes associated with a home packed of loud adolescent kids, but because it’s the first time she will debut her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a facelift, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the skin downward with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes looseness in the dermis – combined with the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the whole facial structure as a unified block allows for a more natural-looking and more durable result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended 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 young,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they present. “A lot of doctors don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state 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 list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|