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

Amanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. Not for the typical reasons related to a house full of clamorous adolescent children, but since it’s the first time she will debut her new face to friends and extended family. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of half a dozen aesthetic surgeries, including an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the first time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a ten years prior to most doctors’ typical patient age range of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a major surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we age. “Human faces are structured a little like onion layers,” explains based in Kent face specialist Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and drags the skin down with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the skin – alongside the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, celebrity-endorsed operative methods are attracting a different type of customer towards this invasive surgery. Reports show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

“Patients are now requesting to look like the best version of themselves and naturally the techniques are following,” says Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling surgeons to reshape the face by repositioning the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Lifting the whole facial structure as a unified block results in a more natural-looking and more durable result. It additionally implies that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have indicated that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we call ‘puffy appearance’ is also the reality that in a sense, the face becomes somewhat fluid-filled because its ability to remove bodily fluid has been diminished.” Though studies into the area is early-stage, warnings on injectables’ potential impact on the lymphatic system have been released, and further research announced. An esteemed facial plastic surgeon, commenting anonymously, says he would avoid using injectables in a patient because of the risks they present. “Many surgeons don’t want to discussing this, because the companies who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it began moving to different areas 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 injectable hamster wheel. Two years later, she ended up selecting from a selection of recommended hotels in the city, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the correct option for the laxity she was finding in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will lift the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will contour your face.’ Thus I ultimately including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day surgery, including a three-day|