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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the usual reasons related to a home packed of clamorous adolescent children, but because it’s the first time she will reveal her new face to acquaintances and relatives. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not how I appear,’” states the 30-year-old property agent from south Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the professional guideline of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based 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 observe people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the dermis downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Statistics show an 8% increase in facelifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with one-third of procedures now performed on individuals aged 35-55.

“People are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to reshape the face by moving the underlying layers, and preventing the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Elevating the whole facial structure as a unified block 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 anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the thirty years old. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Though research into the area is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the dangers they pose. “Many surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The day before her operation, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|