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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes related to a house full of clamorous adolescent kids, but since it’s the initial occasion she will debut her new face to friends and extended family. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen aesthetic surgeries, such as an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband teared up when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals electing to undergo a facelift in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe people choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what becomes lax and pulls the skin downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and causes laxity in the skin – alongside the widespread use of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Reports indicate an eight percent rise in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the superficial layer, the deep plane facelift loosens the underlying structures underneath, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Lifting the whole facial structure as a single unit results in a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the injectable 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.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block drainage pathways. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat waterlogged because its ability to remove bodily fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would avoid using fillers in a client because of the dangers they present. “A lot of surgeons avoid talk about this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she ended up selecting from a selection of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, one day after she’d arrived alone in the country, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|