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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the usual reasons related to a home packed of clamorous preteen children, but since it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a facelift in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Our faces are built a bit like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the skin downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not advisable for an conscientious surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the dermis – combined with the widespread use of slimming medications, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Reports show an 8% increase in facelifts over the last year in the UK; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures underneath, enabling surgeons to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable result. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat waterlogged because its ability to drain bodily fluid has been diminished.” Though studies into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a client because of the dangers they present. “Many doctors don’t want to talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|