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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the typical causes related to a home packed of loud preteen children, but since it’s the initial occasion she will showcase her new face to friends and relatives. “Obviously I’m going to inform all guests as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of people electing to undergo a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties 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 surgery, and I’m a bit concerned when I see people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the skin downward with it.”

You risk operating on people that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes laxity in the dermis – alongside the widespread use of slimming medications, low-cost surgical travel, and the advancement of new, celebrity-endorsed surgical techniques are driving a new kind of customer towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the methods are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the underlying structures underneath, enabling doctors to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at minimum not at the thirty years old. But long-term using injectable gels 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 clarifies. “I underwent it because the injectable harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be where I’m at right now.”

If injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely completely dissolve,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is additionally the fact that to some extent, the face becomes slightly waterlogged because its ability to remove bodily fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using injectables in a client because of the dangers they pose. “A lot of doctors don’t want to talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when 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 face and neck lift could be what she required to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The day before her operation, 24 hours post she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|