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

Amanda Preisinger is nervous about her daughter’s impending 13th birthday party. It’s not due to the usual reasons related to a house full of clamorous preteen kids, but because it’s the initial occasion she will showcase her new face to acquaintances and extended family. “Obviously I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen 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 six cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Human faces are structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the dermis – combined with the common adoption of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a new kind of patient towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves lifting the superficial layer, the deep plane facelift releases the facial ligaments underneath, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis follows along as a secondary element.” Lifting the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” says Grover.

Individual Experience

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 “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

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,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to drain bodily fluid has been diminished.” Though studies into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been released, and further research initiated. 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 avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a list of suggested accommodations in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|