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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the usual causes associated with a home packed of clamorous preteen kids, but since it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – look is the result of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to have a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue known as 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 loosens and sags and pulls the dermis down with it.”

You endanger operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons 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 underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It additionally implies that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be in this situation right now.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” states Grover, “but they move 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 becomes slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Though research into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, commenting anonymously, mentioned he would never use fillers in a client because of the risks they present. “Many doctors avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the cycle of treatments. Two years later, she ended up choosing between a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facial lift 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 eve of her operation, one day after she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|