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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the usual causes associated with a house full of loud adolescent kids, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not the way I look,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – look is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to have a facelift in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we grow older. “Our faces are structured 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 known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and pulls the dermis down with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the skin – combined with the widespread use of slimming medications, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a study revealed that the portion of youthful candidates is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift involves elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue 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 result. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But years of 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 desired to appear youthful,” she says. “I underwent it because the injectable harmed my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

Whether dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face gets somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is preliminary, warnings on injectables’ possible effects on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use fillers in a client because of the risks they present. “A lot of surgeons avoid discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|