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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the typical reasons related to a home packed of clamorous adolescent kids, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” states the 30-year-old real estate agent from south Florida.

Her appearance is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a rising count of people choosing to have a facelift in their twenties and thirties – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have individuals in their late twenties requesting facial lifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are built a bit like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the structural foundation of the face. And that’s what causes aging; that is what loosens and sags and drags 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 follow

Previously reserved of moneyed older people, “filler fatigue” – when overuse of injectable gels expands the face and causes laxity in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facelifts over the past 12 months in the UK; while a study revealed that the percentage of youthful candidates is increasing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to look like the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique promoted by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional rhytidectomy entails elevating the SMAS, the comprehensive lift releases the underlying structures underneath, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is repositioned. The dermis follows along as a passenger.” Elevating the whole facial structure as a unified block allows for a authentic-appearing and more durable outcome. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they move and can obstruct lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is also the reality that to some extent, the face gets somewhat waterlogged because its ability to remove bodily fluid has been diminished.” Though research into the topic is preliminary, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, speaking anonymously, says he would never use injectables in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the companies who make filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors facing court orders after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she felt as if she had to keep replenishing it – especially as it started to migrate to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery could be what she required to exit the injectable hamster wheel. Two years later, she ended up selecting from a list of suggested accommodations in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an eyelid surgery – better known as eyelid surgery – but her surgeon advised her that a facelift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I think if we extract some cheek fat, it will sculpt 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|