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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical reasons related to a home packed of clamorous adolescent children, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘For your information, this is not the way I look,’” states the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to have a facelift in their 20s and 30s – significantly before a ten years before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis down with it.”

You endanger operating on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the skin – combined with the common adoption of slimming medications, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are following,” 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 conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using injectables in a client because of the dangers they pose. “Many surgeons don’t want to talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when 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 face and neck lift might be what she required to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|