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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes associated with a home packed of loud preteen children, but because it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not how I look,’” states the 30-year-old property agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers stretches the face and causes laxity in the dermis – alongside the widespread use of slimming medications, 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 facelifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the SMAS, the comprehensive lift releases the underlying structures underneath, allowing surgeons to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing 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 skin follows along as a secondary element.” Lifting the whole facial structure as a unified block allows for a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat fluid-filled because its capacity to remove bodily fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies initiated. An esteemed face specialist, speaking on the condition of anonymity, says he would avoid using fillers in a client because of the dangers they present. “Many doctors avoid talk about this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down alone in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|