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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. Not for the usual reasons associated with a home packed of clamorous preteen kids, but since it’s the initial occasion she will reveal her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they arrive, ‘For your information, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the outcome of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My spouse teared up when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of forty to sixty. (Though most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals choosing it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a facelift, elevates the tissues in the face that begin to droop as we grow older. “Human faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a stratum of supportive tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin down with it.”

You endanger operating on people that have underlying problems. It’s not advisable for an conscientious surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when overuse of dermal fillers stretches the face and causes looseness in the dermis – combined with the common adoption of weight-loss drugs, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of customer towards this invasive surgery. Reports show an 8% increase in facial lifts over the past 12 months in the United Kingdom; while a survey found that the percentage of younger facelift patients is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the superficial layer, the deep plane facelift releases the underlying structures underneath, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched look occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, 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 skin comes with it as a secondary element.” Elevating the whole facial structure as a single unit results in a authentic-appearing and longer-lasting result. It additionally implies that the surgery is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facelift – at least not at the age of 30. But years of using hyaluronic acid dermal fillers in an effort at “facial balancing” meant that by the time she entered her late twenties, she was “botched”. “I didn’t do this because I wanted to look youthful,” she clarifies. “I underwent it because the filler ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be where I’m at right now.”

If injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they migrate 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 becomes somewhat fluid-filled because its ability to remove lymphatic fluid has been reduced.” Although research into the topic is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking anonymously, says he would never use fillers in a client because of the risks they pose. “A lot of doctors avoid talk about this, because the companies who make filler can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

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 just 28 when a local plastic surgeon in the state proposed that a facial and neck surgery could be what she needed to exit the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her doctor advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, one day after she’d touched down alone in Turkey, she decided to add a lip lift. “Then he said, ‘We will lift the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will contour your face.’ So I ended up adding two more surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, plus a three-day|