‘My Eyes Were So Puffy I Couldn’t Even Open Them’

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the typical reasons associated with a home packed of clamorous adolescent kids, but because it’s the initial occasion she will showcase her new face to acquaintances and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not how I appear,’” says 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 secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals electing to have a facelift in their 20s and 30s – well over a ten years before typical surgeons’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We treat 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 very significant surgery, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; 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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to looseness in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a different type of customer towards this invasive surgery. Reports show an eight percent rise in facial lifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity 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. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “Many surgeons avoid discussing this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift 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. “Then he stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|