‘My Eyes Were So Puffy I Was Unable to Even Unseal Them’

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical causes associated with a house full of loud preteen children, but since it’s the initial occasion she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” 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 opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS 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 operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Reports show an 8% increase in facial lifts over the last year in the UK; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift loosens the underlying structures beneath it, allowing doctors to restructure the face by moving the underlying layers, and preventing the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a authentic-appearing and longer-lasting result. It also means that the surgery is not just being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the injectable 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 point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Though studies into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed face specialist, speaking anonymously, says he would never use fillers in a patient because of the dangers they pose. “Many surgeons don’t want to talk about this, because the companies who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor 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 ended up choosing between a list of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facial lift was the correct option for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|