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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. Not for the usual causes associated with a house full of loud adolescent kids, but because it’s the first time she will debut her new face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a facelift in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and drags the skin downward with it.”

You risk operating on people that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional facelift involves lifting the superficial layer, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But years of using injectable gels in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the fact that to some extent, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although studies into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she found herself choosing between a selection of suggested accommodations in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|