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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday party. Not for the usual reasons associated with a home packed of loud adolescent kids, but since it’s the first time she will showcase her new face to acquaintances and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people choosing to have a facelift in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not age.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue called the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged 35-55.

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

Advanced Lifting Method

Where a conventional facelift entails elevating the superficial layer, the comprehensive lift releases the facial ligaments underneath, allowing doctors to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at minimum not at the age of 30. But years of using injectable gels in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “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 right now.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly waterlogged because its capacity to drain bodily 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 initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use fillers in a client because of the risks they present. “A lot of surgeons avoid talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep 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 the state proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up 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 eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|