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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the typical causes associated with a home packed of clamorous preteen children, but since it’s the first time she will reveal her new face to friends and relatives. “Obviously I’m going to inform all guests as they arrive, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via online call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facelifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are built a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and pulls the skin down with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting a different type of customer towards this invasive surgery. Reports show an eight percent rise in facelifts over the last year in the UK; while a survey revealed that the percentage of younger facelift patients is increasing, with one-third of procedures now conducted for patients aged 35-55.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face becomes slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, says he would never use fillers in a patient because of the dangers they pose. “Many surgeons don’t want to talk about this, because the companies who produce injectables can be quite forceful.” He’s heard stories, he adds, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to exit the injectable hamster wheel. After 24 months, she found herself selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the laxity she was experiencing 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 arrived solo in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|