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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the usual causes related to a house full of clamorous preteen children, but since it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people electing to have a facelift in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (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,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that start to sag as we grow older. “Human faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and causes laxity in the skin – alongside the common adoption of slimming medications, cut-price medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a new kind of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails lifting the superficial layer, the deep plane facelift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting result. It also means 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 “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. 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 do this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Though research into the area is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies announced. One highly regarded face specialist, speaking anonymously, mentioned he would never use injectables in a client because of the risks they present. “A lot of surgeons avoid talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s heard stories, 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 felt as if she needed to continue 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 required to finally step off the injectable hamster wheel. After 24 months, she ended up choosing between a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the laxity 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 touched down alone in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|