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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual reasons related to a home packed of clamorous adolescent kids, but since it’s the initial occasion she will debut her new face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse 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: ‘Babe, I’m okay, I’m not in pain. 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 people electing to undergo a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I see people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, cut-price surgical travel, and the development of new, celebrity-endorsed operative methods are driving a different type of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

If injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the risks they present. “A lot of surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her surgery, one day after she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|