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

Amanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the typical reasons related to a house full of loud preteen kids, but since it’s the first time she will reveal her new face to acquaintances and relatives. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a somewhat startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – look is the result of six cosmetic procedures, such as an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional 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 video call from her house. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is one of a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of 40 to 60. (Although most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people choosing it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a little like onion layers,” says Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of supportive tissue called the SMAS. Think of the SMAS as the structural foundation of the face. And that is what ages us; that’s what becomes lax and drags the skin downward with it.”

You risk performing surgery on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when overuse of injectable gels expands the face and leads to looseness in the dermis – alongside the common adoption of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a different type of customer towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a study found that the portion of youthful candidates is growing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. Currently, the trending procedure is the deep plane facelift, a technique promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy entails elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, enabling surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing stress on the dermis because we’re targeting deeper, to the underlying structures,” says prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a more natural-looking and longer-lasting outcome. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries 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 long-term using injectable gels in an attempt at “facial balancing” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be in this situation currently.”

If injectable substances ever fully dissolve has historically been a debated topic in the aesthetics industry. “Research have indicated that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although studies into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the risks they present. “Many surgeons don’t want to discussing this, because the companies who make filler can be quite forceful.” He’s heard stories, he adds, of cosmetic doctors being landed with court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue adding more – particularly when it began moving to other parts 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 required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – 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 cheek lift and a jawline surgery. The day before her operation, one day after she’d touched down solo in the country, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ Then he said, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|