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

Amanda Preisinger experiences worry about her child’s impending 13th birthday celebration. It’s not due to the usual reasons associated with a home packed of clamorous preteen kids, but since it’s the first time she will debut her recently altered face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, such as an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals electing to undergo a rhytidectomy in their 20s and 30s – well over a ten years prior to most doctors’ usual candidate age of 40 to 60. (Though most surgeons are eager to highlight the industry edict of: “We address genetics, not years.”) “I have individuals in their late twenties requesting facial lifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see people choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we grow older. “Human faces are structured a bit like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and pulls the skin downward with it.”

You risk operating on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the skin – combined with the widespread use of slimming medications, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of patient towards this major operation. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study found that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“People are asking now to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a more traditional facelift involves lifting the superficial layer, the comprehensive lift releases the underlying structures beneath it, allowing surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched appearance sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block results in a authentic-appearing and longer-lasting result. It also means that the surgery 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,” says Grover.

Personal Journey

Preisinger had never planned on getting a facelift – 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 twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a point of contention in the cosmetic field. “Research have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can block drainage pathways. A contributing factor to what we term ‘pillow face’ is additionally the fact that in a sense, the face gets slightly waterlogged because its capacity to remove bodily fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed face specialist, speaking anonymously, says he would never use fillers in a client because of the dangers they pose. “Many surgeons don’t want to talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in Florida suggested that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. Two years later, she found herself choosing between a selection of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her surgeon advised her that a facelift was the right solution for the looseness she was experiencing in her face. She booked a forehead lift, a mid-facelift and a neck lift. The day before her surgery, 24 hours post she’d touched down alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|