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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the usual causes associated with a home packed of clamorous adolescent kids, but since it’s the first time she will reveal her new face to acquaintances and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and pulls the dermis downward with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are driving a new kind of patient towards this major operation. Statistics show an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to reshape the face by moving the underlying layers, and preventing the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Lifting the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – 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 undergo this because I desired to appear young,” she says. “I did it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using 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 pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift might be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|