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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the usual reasons related to a house full of clamorous adolescent kids, but because it’s the first time she will showcase her new face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the result of six aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he viewed me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states 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 somewhat worried when I observe people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and drags the skin downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports show an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to look like the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled look sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Lifting the whole facial structure as a unified block results in a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly waterlogged because its capacity to drain bodily fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a patient because of the risks they pose. “A lot of doctors avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift could be what she required to finally step off the cycle of treatments. Two years later, she ended up choosing between a selection of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|