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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the typical reasons associated with a house full of clamorous preteen children, but because it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she tells me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties asking for facelifts,” states based in London cosmetic 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 people opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we grow older. “Our faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the SMAS. Consider the facial framework as the structural foundation of the face. And that is what causes aging; that is what becomes lax and drags the dermis downward with it.”

You risk performing surgery on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and leads to looseness in the dermis – combined with the common adoption of slimming medications, low-cost surgical travel, and the development of novel, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this major operation. Reports indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study found that the portion of youthful candidates is growing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is adjusted. The dermis comes with it as a secondary element.” Elevating the whole facial structure as a unified block results in a authentic-appearing and more durable result. It also means that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I wanted to look young,” she clarifies. “I did it because the injectable harmed my face. I regret ever done it. If I had avoided the filler, I don’t think I would be in this situation currently.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘pillow face’ is additionally the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to drain lymphatic fluid has been reduced.” Though research into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and further research announced. One highly regarded face specialist, commenting anonymously, mentioned he would avoid using fillers in a patient because of the dangers they present. “Many doctors don’t want to discussing this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of cosmetic doctors being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – particularly when it started to migrate to different areas 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. Two years later, she ended up selecting from a list of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the correct option for the laxity 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 arrived alone in Turkey, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|