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

Onemanda Preisinger is nervous about her child’s impending 13th birthday party. It’s not due to the typical reasons related to a house full of loud preteen children, but since it’s the first time she will showcase her new face to friends and extended family. “Obviously I’m going to inform everyone as they come in, ‘Just so you know, this is not how I look,’” states the 30-year-old real estate agent from south Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last 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’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is one of a rising count of individuals electing to have a rhytidectomy in their twenties and thirties – well over a ten years before typical surgeons’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the professional guideline of: “We treat genetics, not years.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a bit like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Consider the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what becomes lax and drags the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not advisable for an conscientious surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Reports indicate an 8% increase in facial lifts over the past 12 months in the UK; while a study revealed that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged 35-55.

“People are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique promoted 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 deep plane facelift loosens the underlying structures underneath, enabling surgeons to restructure the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing tension on the dermis because we’re going below, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a unified block allows for a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable ruined my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a point of contention in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” states Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly waterlogged 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 lymphatic system have been issued, and further research initiated. An esteemed facial plastic surgeon, commenting on the condition of anonymity, 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 produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might 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 Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor recommended that a facelift was the correct option for the laxity she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The eve of her surgery, 24 hours post she’d touched down alone in the country, she decided to add a lip lift. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I believe if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|