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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual reasons related to a home packed of clamorous preteen kids, but because it’s the initial occasion she will debut 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 30-year-old property agent from south Florida.

Her appearance is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is among a growing number of people electing to have a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see individuals choosing it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Human faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a layer of connective tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that is what becomes lax and drags the skin down with it.”

You endanger performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the skin – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the advancement of new, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Statistics indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves lifting the superficial layer, the deep plane facelift loosens the facial ligaments beneath it, allowing surgeons to reshape the face by repositioning the deeper tissue, and preventing the tight, stretched look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says Harley Street 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.” Elevating the whole facial structure as a unified block allows for a more natural-looking and longer-lasting result. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face becomes somewhat fluid-filled because its ability to drain bodily fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using injectables in a patient because of the risks they pose. “A lot of doctors avoid discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state suggested 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 recommended hotels in Istanbul, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|