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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the typical reasons related to a house full of loud preteen kids, but because it’s the first time she will reveal her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a facelift in their twenties and thirties – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that is what becomes lax and drags the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails elevating the superficial layer, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to reshape the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Research have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would avoid using fillers in a patient because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|