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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons associated with a home packed of loud preteen children, but since it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a little like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and pulls the dermis downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and causes looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed operative methods are attracting a new kind of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to look like the optimal form of themselves and obviously the methods are following,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the facial ligaments underneath, enabling surgeons to reshape the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable outcome. It also means that the surgery is not just being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied 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 regret ever done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the dangers they present. “Many doctors don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could 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, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d touched down solo in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate 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 (£16,500) for the half-day operation, including a three-day|