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

Onemanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the typical causes associated with a house full of clamorous preteen kids, but because it’s the initial occasion she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I look,’” says the 30-year-old real estate agent from Southern Florida.

How she looks is, admittedly, a little startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My poor husband became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, I’m not in pain. I just appear as if someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a facelift in their twenties and thirties – significantly before a ten years before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We treat 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 very significant surgery, and I’m a somewhat worried when I see people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are built a little like onion layers,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Consider the facial framework as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and pulls the skin downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the widespread use of slimming medications, low-cost surgical travel, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this major operation. Reports indicate an 8% increase in facelifts over the last year in the United Kingdom; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to appear as the optimal form of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy involves lifting the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to restructure the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is repositioned. The skin follows along as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum 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 undergo this because I wanted to look young,” she says. “I did 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 in this situation right now.”

If injectable substances completely disappear has historically been a point of contention in the cosmetic field. “Research have shown that they seldom fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the fact that in a sense, the face becomes slightly fluid-filled because its ability to remove bodily fluid has been reduced.” Though research into the area is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, mentioned he would never use injectables in a client because of the dangers they pose. “Many surgeons avoid discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue replenishing it – especially as it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested 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 the city, sent to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a neck lift. The eve of her operation, 24 hours post she’d arrived solo in the country, she opted to include a mouth enhancement. “Then he stated, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (£16,500) for the half-day operation, including a three-day|