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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons related to a house full of loud adolescent kids, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals electing to have a rhytidectomy in their twenties and thirties – significantly before a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the dermis downward with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a survey found that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to appear as the best version of themselves and naturally the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, allowing doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting stress on the skin because we’re going below, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting 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 terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I underwent it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Though research into the topic is early-stage, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, speaking anonymously, says he would never use fillers in a patient because of the risks they pose. “A lot of surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a list of recommended hotels 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 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 mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in the country, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ 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 (£16,500) for the half-day operation, including a three-day|