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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons related to a home packed of loud adolescent kids, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to inform everyone as they arrive, ‘Just so you know, this is not the way I look,’” states the thirty-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a rising count of people electing to undergo a facelift in their 20s and 30s – significantly before a ten years before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the ligaments in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what loosens and sags and drags the dermis down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and leads to looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this invasive surgery. Statistics show an eight percent rise in facelifts over the last year in the UK; while a survey found 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 best version of themselves and naturally the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling doctors to reshape the face by moving the deeper tissue, and avoiding the taut, pulled look sometimes wrought by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its capacity to drain lymphatic fluid has been reduced.” Though research into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a patient because of the dangers they pose. “Many surgeons avoid talk about this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a local plastic surgeon 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 list of recommended hotels in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor recommended that a facial lift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The day before her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a lip lift. “Then he said, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe 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 half-day operation, plus a three-day|