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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the usual reasons associated with a house full of loud adolescent children, but because it’s the initial occasion she will debut her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from south Florida.

How she looks is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ 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 individuals in their late twenties requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built 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 called the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels stretches the face and leads to looseness in the dermis – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of new, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – 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 wanted to look youthful,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

If dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Though studies into the area is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the risks they present. “Many surgeons don’t want to talk about this, because the manufacturers who make filler can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her 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 operation, one day after she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|