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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a home packed of loud adolescent kids, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from Southern 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, temporary – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the first 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 needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facial lifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers stretches the face and causes laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a study revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to look like the best version of themselves and obviously the methods are evolving,” 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

Where a more traditional facelift involves lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever done it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that they seldom completely dissolve,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face becomes slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Although studies into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they present. “Many doctors avoid discussing this, because the companies who produce filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue adding more – especially as it started to migrate 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 exit the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived 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 remove some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|