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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a house full of clamorous preteen kids, but since it’s the first time she will debut her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I look,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a little startling – her face puffed up and unnaturally tightened, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, last month. “My poor husband became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

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 prior to typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I observe people 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 grow older. “Human faces are structured a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the skin downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels expands the face and causes looseness in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are driving a new kind of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to reshape the face by moving the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a more natural-looking and more durable result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facial lift – at minimum not at the thirty years old. But long-term using injectable gels in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face becomes slightly fluid-filled because its capacity to remove bodily fluid has been reduced.” Although studies into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the dangers they pose. “Many surgeons avoid discussing this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she believed she had to keep adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in the state proposed that a face and neck lift could be what she required to finally step off the injectable hamster wheel. Two years later, she ended up selecting from a list of recommended hotels in the city, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She booked a brow lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down alone in the country, she opted to include a lip lift. “Then he stated, ‘We’re going to elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ Thus I ultimately adding two more procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|