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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a house full of clamorous adolescent kids, but because it’s the first time she will showcase her new face to friends and relatives. “Clearly I’m going to inform everyone as they arrive, ‘For your information, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people electing to undergo a facelift in their twenties and thirties – well over a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds asking for facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are structured a little like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and drags the skin down with it.”

You risk performing surgery on individuals that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes looseness in the dermis – alongside the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“People are now requesting to look like the best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the underlying structures underneath, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I had avoided the filler, I don’t think I would be where I’m at currently.”

If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face gets slightly fluid-filled because its ability to remove bodily fluid has been diminished.” Although studies into the area is preliminary, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been issued, and additional studies announced. An esteemed facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the companies who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she had to keep adding more – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a selection of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facial lift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|