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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the usual reasons related to a home packed of clamorous preteen kids, but since it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the initial time because I wasn’t able to even unseal 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 okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to have a rhytidectomy in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a facelift, elevates the tissues in the face that begin to droop as we grow older. “Human faces are structured a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the dermis down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and causes laxity in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the fact that to some extent, the face becomes somewhat waterlogged because its capacity to remove lymphatic fluid has been diminished.” Though studies into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they pose. “A lot of doctors don’t want to discussing this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to exit the cycle of treatments. Two years later, she ended up selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|