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

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. Not for the usual reasons related to a house full of loud adolescent children, but because it’s the first time she will reveal her recently altered face to friends and relatives. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not how I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin down with it.”

You endanger operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are driving a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails elevating the SMAS, the deep plane facelift releases the underlying structures underneath, enabling doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis 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 underlying layers that is adjusted. The skin follows along as a passenger.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, 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 aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the fact that to some extent, the face becomes slightly fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though research into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they present. “Many doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|