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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the typical causes related to a home packed of loud adolescent children, but because it’s the first time she will reveal her new face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I look,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional 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 video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a facelift, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the skin down with it.”

You risk performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a different type of customer towards this major operation. Statistics indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin 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 underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at least not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its ability to remove bodily fluid has been reduced.” Although studies into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they pose. “A lot of surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a face and neck lift might be what she needed to exit the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged 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 lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, plus a three-day|