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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. It’s not due to the usual causes related to a house full of loud preteen children, but since it’s the first time she will reveal her new face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial 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: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are built a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the advancement of new, celebrity-endorsed operative methods are attracting a different type of patient 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 growing, with one-third of procedures now performed on individuals aged 35-55.

“People are asking now to appear as the best version of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the SMAS, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by moving the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a more natural-looking and more durable result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the filler harmed my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been reduced.” Though research into the topic is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a client because of the risks they present. “A lot of doctors don’t want to discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested 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 suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a cheek lift and a neck lift. The day before her surgery, one day after she’d arrived alone in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|