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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the usual causes related to a house full of loud preteen kids, but because it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the result of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to have a rhytidectomy in their 20s and 30s – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a somewhat worried when I see people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed surgical techniques are attracting a different type of patient towards this major operation. Reports indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling surgeons to restructure the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to remove lymphatic fluid has been diminished.” Although studies into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue adding more – especially as 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 list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|