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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the usual reasons associated with a house full of loud adolescent kids, but because it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – 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 outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals choosing to have a facelift in their twenties and thirties – significantly before a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and pulls the skin downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are driving a new kind of customer towards this major operation. Reports show an eight percent rise in facelifts over the last year in the United Kingdom; while a survey found that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are asking now to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift involves lifting the superficial layer, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to restructure the face by moving the deeper tissue, and preventing the tight, stretched appearance occasionally caused by older methods. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Though studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, 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 risks they pose. “Many surgeons avoid talk about this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

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 suggested that a face and neck lift might 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 doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|