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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes related to a home packed of loud preteen children, but since it’s the initial occasion she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat 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 – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and pulls the skin downward with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and leads to looseness in the dermis – combined with the common adoption of slimming medications, cut-price surgical travel, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to reshape the face by moving the underlying layers, and avoiding the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable outcome. It also means that the surgery is not just 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 patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though studies into the topic is early-stage, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a patient because of the dangers they pose. “A lot of surgeons avoid discussing this, because the companies who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift might be what she required to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her 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 day before her surgery, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|