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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons related to a house full of loud adolescent children, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the result of six cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are built a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the skin downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the skin – alongside the widespread use of slimming medications, low-cost surgical travel, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facelifts over the past 12 months 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.

“People are now requesting to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis 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 adjusted. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” implied 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 underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation right now.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face gets slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a patient because of the risks they pose. “A lot of doctors avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue 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 might be what she needed to finally step off the injectable hamster wheel. After 24 months, she ended up selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|