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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a home packed of loud adolescent children, but because it’s the first time she will reveal her new face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people 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 begin to droop as we age. “Human faces are structured a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the skin down with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and causes looseness in the dermis – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

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

Advanced Lifting Method

While a more traditional facelift entails lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But years of using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a patient because of the dangers they pose. “Many surgeons avoid discussing this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep adding more – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a selection of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she opted to include a lip lift. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|