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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the typical causes related to a house full of loud adolescent kids, but since it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and drags the dermis downward with it.”

You endanger operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – alongside the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a different type of patient towards this major operation. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of younger facelift patients is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails lifting the SMAS, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear 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 think I would be in this situation currently.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the fact that in a sense, the face becomes somewhat waterlogged because its capacity to remove lymphatic fluid has been reduced.” Although research into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been released, and additional studies initiated. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would never use injectables in a client because of the risks they pose. “Many surgeons don’t want to discussing this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery could be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|