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

Amanda Preisinger feels anxious about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes related to a home packed of loud adolescent children, but since it’s the first time she will reveal her new face to acquaintances and extended family. “Clearly I’m going to tell all guests as they arrive, ‘For your information, this is not how I appear,’” says the 30-year-old property agent from Southern Florida.

Her appearance is, admittedly, a little startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, temporary – look is the outcome of six aesthetic surgeries, such as an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Though many specialists are keen to emphasise the professional guideline of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what becomes lax and pulls the skin downward with it.”

You risk operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are driving a new kind of customer towards this major operation. Statistics show an 8% increase in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with 32% of facelifts now conducted for individuals aged 35-55.

“People are asking now to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift releases the underlying structures underneath, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the taut, pulled look sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” 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 facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “facial balancing” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I had avoided the filler, I don’t think I would be in this situation currently.”

If injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we term ‘pillow face’ is also the reality that in a sense, the face gets slightly fluid-filled because its capacity to drain bodily fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and additional studies announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a client because of the risks they present. “Many surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a face and neck lift might 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 planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor advised her that a facial lift was the right solution for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d touched down solo in the country, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up adding two more surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|