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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the typical reasons related to a house full of clamorous preteen kids, but because it’s the initial occasion she will debut her recently altered face to friends and relatives. “Clearly I’m going to inform everyone as they come in, ‘Just so you know, this is not the way I appear,’” says 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 altered – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of individuals electing to have a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ typical patient age range of forty to sixty. (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 facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “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 facelift, alternatively called a facelift, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the SMAS. Consider 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 dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached 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 wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Although research into the area is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a patient because of the dangers they present. “A lot of surgeons don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|