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

Amanda Preisinger experiences worry about her child’s upcoming 13th birthday party. It’s not due to the typical causes associated with a house full of clamorous adolescent kids, but because it’s the first time she will debut her recently altered face to friends and extended family. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what ages us; that is what loosens and sags and pulls the skin downward with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and causes laxity in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of new, celebrity-endorsed operative methods are driving a new kind of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“People are asking now to look like the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the tight, stretched look occasionally caused by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and more durable outcome. It additionally implies that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “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 think I would be in this situation right now.”

If injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face becomes slightly waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “Many surgeons avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor recommended 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 jawline surgery. The day before her operation, one day after she’d arrived alone in the country, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|