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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. It’s not due to the typical reasons associated with a house full of loud adolescent kids, but since it’s the initial occasion she will debut her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he saw 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 home. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals electing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider 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 people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the skin – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of novel, celebrity-endorsed operative methods are attracting a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the methods are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t think I would be in this situation right now.”

If dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat waterlogged because its capacity to drain bodily fluid has been reduced.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they present. “Many surgeons don’t want to talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, including a three-day|