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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. Not for the typical reasons related to a home packed of clamorous preteen kids, but because it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of people electing to undergo a facelift in their 20s and 30s – well over a decade before most doctors’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant 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 facelift, elevates the tissues in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that is what ages us; that is what becomes lax 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 pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, cut-price medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the UK; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are asking now to appear as the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves elevating the superficial layer, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes slightly waterlogged because its ability to drain bodily fluid has been diminished.” Though research into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use fillers in a client because of the dangers they pose. “A lot of surgeons avoid discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a face and neck lift might be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d arrived alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|