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

Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes associated with a home packed of loud preteen kids, but since it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I look,’” states the thirty-year-old property agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – appearance is the outcome of six aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via online call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of people electing to have a rhytidectomy in their twenties and thirties – well over a ten years before most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat heredity, not years.”) “I have 28-year-olds requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, lifts the ligaments in the face that begin to droop as we age. “Human faces are built a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Think of the facial framework as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the skin downward with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the skin – combined with the common adoption of slimming medications, low-cost medical tourism, and the development of new, celebrity-endorsed operative methods are driving a new kind of customer towards this major operation. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a survey found that the portion of youthful candidates is increasing, with one-third of procedures now conducted for patients aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift entails lifting the superficial layer, the comprehensive lift loosens the facial ligaments underneath, enabling surgeons to reshape the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The skin comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable outcome. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she reached her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

If injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been issued, and additional studies announced. An esteemed face specialist, commenting anonymously, says he would never use injectables in a client because of the dangers they pose. “A lot of surgeons don’t want to talk about this, because the companies who make injectables can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – especially as it started to migrate to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she needed to finally step off the cycle of treatments. Two years later, she found herself choosing between a list of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, 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 laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I think if we extract some cheek fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the six-hour surgery, including a three-day|