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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the usual causes related to a home packed of loud preteen kids, but since it’s the first time she will reveal her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon 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 tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of patient towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“People are asking now to appear as the best version of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” 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 secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has historically been a point of contention in the cosmetic field. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is early-stage, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded face specialist, speaking anonymously, mentioned he would never use fillers in a client because of the risks they pose. “Many surgeons avoid discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – especially as it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she ended up choosing between a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d touched down solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|