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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a home packed of clamorous preteen children, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property 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 eager to emphasize, temporary – look is the result of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of individuals choosing to have a facelift in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting 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 bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, 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’s what ages us; that’s 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 conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to looseness in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the development of new, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are asking now to appear as 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 figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves lifting the superficial layer, the comprehensive lift releases the underlying structures underneath, allowing surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

Whether dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the dangers they pose. “Many doctors don’t want to talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she found herself choosing between a selection of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|