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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the typical reasons related to a house full of loud adolescent kids, but since it’s the first time she will debut her new face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of six aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years before most doctors’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, 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,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and drags the dermis down with it.”

You risk operating on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the dermis – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Statistics indicate an 8% increase in facelifts over the last year in the UK; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

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

Deep Plane Technique

While a conventional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the facial ligaments underneath, enabling surgeons to restructure the face by moving the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Although studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the dangers they present. “A lot of doctors don’t want to talk about this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|