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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the typical reasons associated with a home packed of loud adolescent children, but since it’s the first time she will debut her new face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even open my eyes. That indicates swollen I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to cosmetic specialists, Preisinger is among a growing number of people choosing to have a facelift in their twenties and thirties – well over a ten years before most doctors’ usual candidate age of 40 to 60. (Though many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “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 facelift, alternatively called a rhytidectomy, lifts the ligaments in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the soft tissue skeleton of the face. And that is what ages us; that is what becomes lax and pulls the dermis down with it.”

You risk performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the UK; while a study found that the portion of younger facelift patients is growing, with one-third of procedures now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift loosens the facial ligaments underneath, allowing surgeons to restructure the face by moving the deeper tissue, and preventing the tight, stretched 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 cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable result. It also means that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has historically been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat fluid-filled because its ability to remove bodily fluid has been reduced.” Although research into the area is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been released, and additional studies announced. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a patient because of the risks they pose. “A lot of doctors avoid discussing this, because the manufacturers who produce filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a list of suggested accommodations in the city, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the correct option for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will elevate the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|