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

Amanda Preisinger experiences worry about her child’s impending 13th birthday party. Not for the typical causes associated with a house full of loud preteen kids, but since it’s the initial occasion she will reveal her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat surprising – 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 result of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last 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 tells me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” states based in London aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the tissues in the face that begin to droop as we grow older. “Our faces are built a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what loosens and sags and drags the dermis down with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and leads to looseness in the skin – alongside the common adoption of slimming medications, cut-price surgical travel, and the development of novel, celebrity-endorsed surgical techniques are driving a different type of customer towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing doctors to restructure the face by moving the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of youth preservation – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing 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” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Studies have indicated that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly waterlogged because its ability to drain bodily fluid has been reduced.” Though research into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use fillers in a client because of the risks they pose. “Many surgeons don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity she was experiencing 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 the country, she opted to include a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|