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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. It’s not due to the typical reasons associated with a home packed of loud adolescent kids, but because it’s the first time she will reveal her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – look is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the skin downward with it.”

You endanger operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and leads to looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Reports indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey found that the percentage of youthful candidates is increasing, with one-third of procedures now conducted for individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, enabling surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor 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.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and more durable result. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But years of using injectable gels in an effort at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, commenting anonymously, says he would avoid using fillers in a client because of the risks they present. “A lot of surgeons avoid discussing this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue adding more – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|