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

Amanda Preisinger experiences worry about her daughter’s impending 13th birthday party. Not for the usual reasons related to a home packed of clamorous preteen children, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and relatives. “Obviously I’m going to inform all guests as they arrive, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before typical surgeons’ typical patient age range of 40 to 60. (Though most surgeons are keen to emphasise the industry edict of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Human faces are structured a little like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that is what ages us; that is what loosens and sags and drags the dermis downward with it.”

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

Previously reserved of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the widespread use of weight-loss drugs, cut-price surgical travel, and the development of novel, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the UK; while a study found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are asking now to appear as the optimal form of themselves and naturally the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a method evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional facelift entails elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, allowing doctors to reshape the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re targeting deeper, to the underlying structures,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin comes with it as a secondary element.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of 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 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 where I’m at right now.”

If injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that in a sense, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although studies into the topic is early-stage, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and additional studies initiated. An esteemed facial plastic surgeon, commenting anonymously, says he would never use fillers in a patient because of the risks they present. “A lot of doctors don’t want to talk about this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her operation, one day after she’d touched down alone in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|