‘My Eyes Were So Puffy I Was Unable to Even Open Them’

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual causes associated with a house full of clamorous adolescent kids, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the 30-year-old property agent from south Florida.

How she looks is, admittedly, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of people choosing to have a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We address heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are structured a little like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat 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’s what ages us; that’s what loosens and sags and pulls the dermis down with it.”

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

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the skin – combined with the widespread use of slimming medications, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Statistics indicate an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is increasing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and naturally the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the underlying structures beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled appearance sometimes wrought by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It additionally implies that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using injectable gels in an attempt at “facial balancing” implied that by the time she reached her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I wish I had never using it. If I had avoided the filler, I don’t believe I would be where I’m at right now.”

If injectable substances ever fully dissolve has historically been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets somewhat waterlogged because its capacity to remove lymphatic fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use fillers in a client because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might 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 doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor 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 day before her operation, 24 hours post she’d arrived alone in the country, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, plus a three-day|