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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual reasons associated with a house full of clamorous preteen kids, but because it’s the initial occasion she will debut her new face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My spouse 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 tells me via online call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to have a facelift in their 20s and 30s – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I see individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human 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 called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and pulls the skin downward with it.”

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

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 common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this invasive surgery. Statistics show an 8% increase in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and naturally the methods are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves elevating the SMAS, the comprehensive lift loosens the underlying structures beneath it, enabling doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched look occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Lifting the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be where I’m at right now.”

Whether injectable substances completely disappear has long been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Although research into the topic is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded face specialist, commenting anonymously, mentioned he would never use fillers in a client because of the risks they pose. “Many surgeons avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep replenishing it – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her surgery, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|