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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the usual causes associated with a house full of loud adolescent kids, but because it’s the initial occasion she will debut her new face to friends and extended family. “Clearly I’m going to tell 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 Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of people choosing to undergo a facelift in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the tissues in the face that begin to droop as we age. “Human faces are structured a bit like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what loosens and sags and pulls the skin down with it.”

You endanger performing surgery on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels expands the face and causes looseness in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of patient towards this invasive surgery. Statistics show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the superficial layer, the deep plane facelift releases the underlying structures underneath, allowing surgeons to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable result. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – 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 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If injectable substances ever fully dissolve 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 move and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the reality that in a sense, the face gets somewhat waterlogged because its ability to remove bodily fluid has been diminished.” Though studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the body’s drainage have been released, and additional studies initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the dangers they pose. “A lot of surgeons avoid discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a selection of recommended hotels in the city, 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 eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The day before her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|