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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the usual causes associated with a house full of loud adolescent kids, but since it’s the initial occasion she will debut her new face to friends and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I appear,’” states the 30-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the result of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – well over a ten years prior to typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We address heredity, not years.”) “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 procedure, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the skin down with it.”

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

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift entails lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the injectable harmed my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that in a sense, the face becomes slightly fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and further research announced. An esteemed facial plastic surgeon, commenting anonymously, mentioned he would never use fillers in a client because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors 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 – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her doctor recommended that a facelift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down solo in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour operation, plus a three-day|