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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual reasons associated with a house full of clamorous adolescent children, but since it’s the first time she will debut her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of people choosing to have a rhytidectomy in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a facelift, elevates the tissues in the face that begin to droop as we grow older. “Human faces are built a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and drags the dermis down with it.”

You risk operating on people that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands 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 surgical techniques are attracting a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are now requesting to look like the best version of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves lifting the SMAS, the deep plane facelift releases the underlying structures underneath, allowing doctors to restructure the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Although research into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, commenting anonymously, says he would never use injectables in a client because of the dangers they present. “A lot of surgeons avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|