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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical causes related to a house full of loud preteen kids, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Explaining 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 built a little like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Reports show an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she says. “I underwent it because the filler ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its ability to remove lymphatic fluid has been reduced.” Though research into the area is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded face specialist, commenting anonymously, says he would never use fillers in a patient because of the dangers they present. “A lot of doctors don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift could be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in Turkey, she decided to add a lip lift. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|