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

Amanda Preisinger is nervous about her child’s impending 13th birthday celebration. Not for the typical reasons associated with a house full of loud adolescent kids, but because it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I appear,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of 40 to 60. (Though most surgeons are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Our faces are structured a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that is what ages us; that is what loosens and sags and pulls the skin downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are now requesting to look like 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 promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift loosens the facial ligaments underneath, enabling surgeons to restructure the face by moving the deeper tissue, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting result. It additionally implies that the surgery is no longer being used for the primary goal of youth preservation – or rejuvenation, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers completely disappear has long been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘pillow face’ is additionally the fact that in a sense, the face gets slightly waterlogged because its capacity to remove 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 additional studies announced. An esteemed facial plastic surgeon, commenting anonymously, says he would never use injectables in a patient because of the risks they present. “A lot of doctors don’t want to talk about this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The day before her surgery, one day after she’d arrived solo in Turkey, she opted to include a mouth enhancement. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|