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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. It’s not due to the typical causes associated with a house full of clamorous adolescent kids, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their 20s and 30s – well over a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to look like the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional facelift involves lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It additionally implies 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 “enhancement” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable 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 currently.”

If dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘pillow face’ is also the reality that in a sense, the face gets slightly fluid-filled because its ability to drain bodily fluid has been diminished.” Though studies into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded face specialist, speaking on the condition of anonymity, says he would never use injectables in a client because of the risks they pose. “Many doctors avoid discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|