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

Amanda Preisinger feels anxious about her child’s impending 13th birthday celebration. Not for the typical causes related to a home packed of loud preteen kids, but because it’s the first time she will reveal her new face to friends and extended family. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not the way I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, temporary – appearance is the outcome of half a dozen cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a rising count of people choosing to undergo a facelift in their twenties and thirties – well over a decade before most doctors’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin down with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and causes laxity in the dermis – combined with the widespread use of slimming medications, low-cost medical tourism, and the development of novel, celebrity-endorsed operative methods are driving a different type of customer towards this invasive surgery. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and naturally the techniques are evolving,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves elevating the superficial layer, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the tight, stretched look sometimes wrought by older methods. “We avoid placing stress on the dermis because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis follows along as a passenger.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting result. It additionally implies that the surgery is not just 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 receive numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended 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” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘pillow face’ is also the fact that to some extent, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Although studies into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the risks they present. “A lot of doctors avoid talk about this, because the companies 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, once she started using injectables, she believed she had to keep replenishing it – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she found herself selecting from a selection of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ Thus I ultimately including additional procedures,” she says. She paid $22,000 (£16,500) for the six-hour operation, plus a three-day|