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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons related to a home packed of clamorous adolescent kids, but since it’s the first time she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I look,’” says the 30-year-old property agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals electing to have a rhytidectomy in their twenties and thirties – significantly before a ten years prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Our faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and pulls the skin downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the UK; while a study revealed that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“People are now requesting to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a more natural-looking and more durable outcome. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I underwent it because the injectable harmed 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 injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat waterlogged because its ability to remove lymphatic fluid has been reduced.” Although research into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a client because of the risks they present. “A lot of doctors avoid discussing this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facelift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|