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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the usual causes associated with a house full of loud preteen kids, but since it’s the initial occasion she will debut her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not how I look,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse 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 tells me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a bit concerned when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients 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 effort at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the injectable harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

If injectable substances completely disappear has long been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although research into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the dangers they pose. “Many surgeons avoid discussing this, because the companies who produce 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, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery could be what she required to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down alone in the country, she opted to include a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|