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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday party. It’s not due to the usual causes associated with a home packed of clamorous preteen children, but since it’s the first time she will reveal her recently altered face to friends and extended family. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” states the thirty-year-old property agent from south Florida.

Her appearance is, well, a somewhat surprising – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – appearance is the result of six cosmetic procedures, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Babe, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a growing number of people electing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We treat genetics, not years.”) “I have individuals in their late twenties asking for facial lifts,” says based in London aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major surgery, and I’m a bit concerned when I observe people opting for it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a bit like onion layers,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue called the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”

You risk operating on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to pursue

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels stretches the face and causes laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are attracting a different type of patient towards this invasive surgery. Statistics indicate an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional facelift involves lifting the superficial layer, the deep plane facelift releases the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It additionally implies that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended 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 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation right now.”

Whether injectable substances ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we call ‘puffy appearance’ is also the fact that to some extent, the face becomes slightly fluid-filled because its capacity to drain bodily fluid has been reduced.” Though studies into the area is early-stage, cautionary statements on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies initiated. One highly regarded face specialist, commenting anonymously, says he would never use fillers in a client because of the dangers they present. “A lot of surgeons don’t want to discussing this, because the manufacturers who make injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning using injectables, she felt as if she had to keep replenishing it – particularly when it started to migrate to different areas of her face. She was just 28 when a local plastic surgeon in the state proposed that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of recommended hotels in the city, sent to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d touched down solo in Turkey, she decided to add a mouth enhancement. “Then he stated, ‘We will elevate the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (£16,500) for the six-hour surgery, including a three-day|