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

Amanda Preisinger feels anxious about her daughter’s impending 13th birthday party. It’s not due to the typical causes related to a home packed of clamorous preteen children, but since it’s the initial occasion she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, well, a little startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the skin downward with it.”

You risk performing surgery on individuals that have underlying problems. It’s not advisable for an conscientious surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to look like the best version of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves elevating the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the filler ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that to some extent, the face becomes slightly fluid-filled because its ability to remove lymphatic fluid has been diminished.” Though research into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use fillers in a client because of the dangers they pose. “Many doctors avoid discussing this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift could be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|