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

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a home packed of loud adolescent children, but since 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,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to have a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and pulls the dermis down with it.”

You risk operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails lifting the superficial layer, the deep plane facelift releases the facial ligaments beneath it, allowing surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit allows for 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 cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the filler, 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 indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is also the fact that in a sense, the face becomes slightly waterlogged because its ability to drain bodily fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, commenting anonymously, mentioned he would avoid using injectables in a patient because of the dangers they pose. “Many doctors don’t want to discussing this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|