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

Amanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical reasons related to a house full of loud preteen children, but since it’s the first time she will debut her new face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, well, a little startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, the previous month. “My poor husband teared up when he viewed me for the initial time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

According to cosmetic specialists, Preisinger is one of a rising count of people electing to undergo a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I see people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and drags the skin down with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the portion of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to restructure the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable result. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, 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 undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I did it because the injectable ruined my face. I regret ever done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and further research initiated. An esteemed face specialist, speaking anonymously, mentioned he would avoid using injectables in a client because of the risks they present. “Many surgeons avoid discussing this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – better known as blepharoplasty – but her doctor advised her that a facelift 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 eve of her surgery, one day after she’d touched down solo in the country, she opted to include a mouth enhancement. “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 sculpt your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, plus a three-day|