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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. Not for the typical causes associated with a home packed of loud preteen kids, but because it’s the initial occasion she will reveal her new face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of people electing to undergo a facelift in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the skin downward with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels stretches the face and leads to laxity in the skin – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and more durable outcome. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its ability to drain lymphatic fluid has been diminished.” Though research into the area is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a patient because of the risks they pose. “A lot of surgeons avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons 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 – especially as it began moving to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|