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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the typical reasons associated with a house full of clamorous preteen children, but because it’s the first time she will showcase her recently altered face to friends and relatives. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from south Florida.

Her appearance is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the result of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their twenties and thirties – well over a decade before most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Human faces are structured a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the skin – alongside the widespread use of weight-loss drugs, cut-price medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a study found that the portion of younger facelift patients is growing, with 32% of facelifts now performed on patients 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 operation du jour is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails elevating the SMAS, the comprehensive lift loosens the facial ligaments beneath it, enabling surgeons to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Though studies into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they present. “Many surgeons avoid talk about this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a selection of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her operation, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|