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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. Not for the usual reasons associated with a house full of clamorous adolescent children, but since it’s the initial occasion she will showcase her new face to friends and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates swollen I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of individuals electing to undergo a rhytidectomy in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and pulls the skin down with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when excessive use of injectable gels expands the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the United Kingdom; while a study revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

If dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “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 in a sense, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would never use injectables in a patient because of the dangers they pose. “A lot of surgeons don’t want to talk about 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 raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|