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

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday party. Not for the usual causes related to a home packed of clamorous adolescent children, but since it’s the initial occasion she will debut her new face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the 30-year-old property agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the result of six cosmetic procedures, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, the previous month. “My spouse became emotional when he viewed me for the initial time because I couldn’t even open my eyes. That indicates puffy I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a facelift in their 20s and 30s – well over a decade prior to typical surgeons’ usual candidate age of forty to sixty. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, lifts the tissues in the face that begin to droop as we age. “Our faces are structured a bit like layers of an onion,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue called 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 dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and leads to looseness in the skin – alongside the common adoption of slimming medications, low-cost surgical travel, and the development of novel, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Statistics indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on patients aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves elevating the superficial layer, the comprehensive lift releases the underlying structures underneath, enabling doctors to restructure the face by repositioning the deeper tissue, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit allows for a more natural-looking and longer-lasting result. It also means that the surgery is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

If dermal fillers completely disappear has historically been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat waterlogged because its ability to remove lymphatic fluid has been reduced.” Though research into the topic is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been released, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, mentioned he would avoid using fillers in a client because of the risks they present. “Many surgeons 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 facing court orders after expressing worries.

Decision and Procedure

For Preisinger, once she started using injectables, she felt as if she had to keep replenishing it – especially as 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 could be what she needed to finally step off the injectable hamster wheel. Two years later, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, one day after she’d arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon said, ‘We will lift the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|