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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. It’s not due to the typical reasons related to a house full of loud adolescent kids, 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 the way I appear,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of individuals choosing to have a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Our faces are built a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that is what becomes lax and pulls 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

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and causes looseness in the skin – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this major operation. Reports show an 8% increase in facial lifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves elevating the superficial layer, the deep plane facelift releases the underlying structures beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It additionally implies that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets slightly waterlogged because its ability to drain bodily fluid has been diminished.” Although research into the area is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would never use injectables in a patient because of the dangers they pose. “Many surgeons don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|