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

Amanda Preisinger feels anxious about her child’s impending 13th birthday party. It’s not due to the typical reasons related to a house full of loud preteen kids, but since it’s the first time she will showcase her recently altered face to acquaintances and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the result of six aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional 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 house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – well over 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 address heredity, not age.”) “I have individuals in their late twenties requesting facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a somewhat worried when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

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

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

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a different type of customer towards this major operation. Reports show an eight percent rise in facelifts over the last year in the United Kingdom; while a study revealed 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 appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing 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 cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on getting a facial lift – 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 entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the filler harmed my face. I wish I had never using it. If I had avoided the filler, I don’t think I would be where I’m at right now.”

If injectable substances completely disappear has historically been a point of contention in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that in a sense, the face becomes slightly waterlogged because its ability to remove bodily fluid has been diminished.” Although studies into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, commenting anonymously, says he would never use fillers in a patient because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who make filler 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 adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to finally step off the cycle of treatments. 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 doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facelift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in the country, she decided to add a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|