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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the typical causes associated with a house full of clamorous adolescent kids, but since it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I had to tell 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 one of a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties 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 very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and drags the dermis downward with it.”

You endanger performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the facial ligaments underneath, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and more durable outcome. It additionally implies that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “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 right now.”

If dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking anonymously, says he would never use injectables in a patient because of the dangers they present. “Many doctors avoid discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she required to finally step off the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will 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 surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|