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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of clamorous adolescent children, but since it’s the first time she will debut her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I look,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she tells me via online call from her house. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals choosing to undergo a rhytidectomy in their 20s and 30s – well over a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a facelift, lifts the tissues in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and pulls the skin down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the dermis – combined with the common adoption of slimming medications, low-cost medical tourism, and the advancement of new, famous-figure-promoted surgical techniques are driving a new kind of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the United Kingdom; while a study revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are now requesting to look like the best version of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift entails lifting the SMAS, the comprehensive lift releases the underlying structures beneath it, enabling doctors to restructure the face by moving the deeper tissue, and preventing the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the dermis because we’re going below, to the deeper tissue,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, 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 undergoing a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I underwent it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

If dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the fact that to some extent, the face gets slightly waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, commenting anonymously, says he would never use fillers in a patient because of the dangers they present. “A lot of doctors avoid discussing this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she required to exit the cycle of treatments. Two years later, she ended up choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|