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

Onemanda Preisinger feels anxious about her daughter’s impending 13th birthday celebration. It’s not due to the usual reasons associated with a home packed of clamorous preteen children, but because it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Clearly I’m going to tell all guests as they come in, ‘Just so you know, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, well, a somewhat startling – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the outcome of six cosmetic procedures, such as an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw 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 online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone attacked me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of individuals electing to undergo a facelift in their 20s and 30s – well over a ten years before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major procedure, and I’m a bit concerned when I see people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that begin to droop as we grow older. “Human faces are built a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of supportive tissue known as the SMAS. Think of the SMAS as the soft tissue skeleton of the face. And that is what ages us; that’s what loosens and sags and pulls the skin down with it.”

You risk operating on individuals that have deeper issues. It’s not advisable for an conscientious surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and leads to looseness in the skin – combined with the widespread use of slimming medications, cut-price surgical travel, and the advancement of new, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the UK; while a survey found that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method promoted by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves elevating the SMAS, the comprehensive lift loosens the underlying structures underneath, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she says. “I did it because the filler harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t think I would be where I’m at currently.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets slightly waterlogged because its ability to drain bodily fluid has been reduced.” Although research into the topic is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and additional studies announced. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a client because of the dangers they pose. “A lot of doctors avoid discussing this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after expressing worries.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a facial and neck surgery might be what she required to finally step off the injectable hamster wheel. Two years later, she found herself selecting from a list of suggested accommodations in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her surgery, 24 hours post she’d arrived alone in Turkey, she opted to include a mouth enhancement. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|