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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. Not for the typical reasons associated with a home packed of clamorous adolescent children, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not how I look,’” states the 30-year-old property 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 new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, 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 wasn’t able to even open my eyes. That’s how swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is among a growing number of people electing to have a facelift in their twenties and thirties – well over a decade prior to most doctors’ typical patient age range of forty to sixty. (Although most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major surgery, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, overuse of injectables – when overuse of dermal fillers expands the face and leads to laxity in the dermis – alongside the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted operative methods are attracting a new kind of patient towards this major operation. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a study revealed that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals 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. Currently, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the superficial layer, the comprehensive lift loosens the facial ligaments beneath it, allowing surgeons to restructure the face by repositioning the underlying layers, and avoiding the taut, pulled appearance occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the underlying structures,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is repositioned. The skin comes with it as a passenger.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It additionally implies that the surgery is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from clients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has long been a debated topic in the cosmetic field. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though research into the area is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using injectables in a patient because of the dangers they present. “A lot of surgeons avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift might be what she needed to exit the cycle of treatments. After 24 months, she ended up choosing between a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – 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 cheek lift and a jawline surgery. The day before her surgery, one day after she’d touched down alone in the country, she opted to include a lip lift. “Then he said, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|