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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. It’s not due to the typical reasons associated with a home packed of clamorous adolescent kids, but because it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Clearly I’m going to inform all guests as they arrive, ‘Just so you know, this is not the way I look,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face swollen and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, performed by a surgeon in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a rising count of individuals electing to undergo a facelift in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have individuals in their late twenties asking for facial lifts,” states 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 choosing it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the tissues in the face that begin to droop as we grow older. “Human faces are structured a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what becomes lax and drags the dermis down with it.”

You endanger operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes laxity in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Statistics indicate an eight percent rise in facial lifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with one-third of procedures now performed on individuals aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the operation du jour is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and longer-lasting outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant 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 underwent it because the injectable 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.”

Whether dermal fillers ever fully dissolve has historically been a point of contention in the cosmetic field. “Research have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been diminished.” Though research into the area is preliminary, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “A lot of doctors avoid talk about this, because the companies who make injectables can be pretty aggressive.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she required to finally step off the cycle of treatments. Two years later, she ended up choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|