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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. Not for the typical reasons associated with a home packed of clamorous preteen children, but because it’s the initial occasion she will showcase her recently altered face to friends and relatives. “Obviously I’m going to tell all guests as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last 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 had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have 28-year-olds requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Human faces are built a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and drags the dermis down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Reports show an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a survey found that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the facial ligaments underneath, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

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 “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I did it because the filler ruined my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a debated topic in the cosmetic field. “Research have indicated that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Though research into the area is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a patient because of the dangers they present. “A lot of doctors avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to exit the injectable hamster wheel. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, 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 blepharoplasty – but her doctor recommended that a facial lift was the right solution for the looseness she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|