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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. Not for the typical causes related to a home packed of clamorous adolescent kids, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – look is the result of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to have a facelift in their 20s and 30s – well over a ten years before typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and pulls the dermis downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this major operation. Statistics indicate an 8% increase 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 conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the superficial layer, the deep plane facelift releases the facial ligaments underneath, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the injectable ruined my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research announced. One highly regarded face specialist, speaking anonymously, says he would avoid using injectables in a client because of the risks they pose. “Many doctors don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon 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 ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in the country, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, plus a three-day|