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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the typical causes related to a home packed 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 inform all guests as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – 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 doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their twenties and thirties – significantly before a ten years before typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, not age.”) “I have individuals in their late twenties asking for facelifts,” says based in London aesthetic plastic 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 see individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and drags the skin downward with it.”

You endanger performing surgery on individuals 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 injectable gels stretches the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are driving a different type of patient towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the United Kingdom; while a study found that the percentage of youthful candidates is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the underlying structures underneath, allowing surgeons to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched look sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the whole facial structure as a single unit allows for 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 revitalization, as the cosmetic field terms it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at minimum not at the age of 30. 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 young,” she says. “I underwent it because the filler harmed my face. I wish I had never using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to drain bodily fluid has been reduced.” Though research into the area is preliminary, warnings on injectables’ potential impact on the body’s drainage have been released, and further research announced. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use fillers in a client because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift might be what she needed to exit the cycle of treatments. Two years later, she found herself selecting from a selection of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|