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

Amanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a house full of clamorous preteen kids, but because it’s the first time she will reveal her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That’s how swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of individuals electing to undergo a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address heredity, not years.”) “I have 28-year-olds requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Our faces are built a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue known as the superficial musculoaponeurotic system. 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 downward with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a new kind of customer towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.

“People are now requesting to look like the best version of themselves and obviously the methods are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the superficial layer, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It additionally implies that the surgery is no longer being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I desired to appear young,” she clarifies. “I underwent it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

If dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Research have shown that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we term ‘pillow face’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its ability to drain lymphatic fluid has been diminished.” Though studies into the area is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “Many surgeons avoid talk about this, because the companies who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she had to keep replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|