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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday celebration. Not for the usual causes associated with a home packed of loud preteen children, but because it’s the initial occasion she will reveal her new face to acquaintances and relatives. “Obviously I’m going to tell everyone as they come in, ‘For your information, this is not the way I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a surgeon in Turkey’s Istanbul, last month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even unseal my eyes. That indicates puffy I was,” she tells me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is among a rising count of people choosing to have a facelift in their 20s and 30s – well over a ten years prior to typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based cosmetic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a major procedure, and I’m a bit concerned when I see individuals opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, elevates the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like onion layers,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the surface, then a stratum of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that is what ages us; that’s what loosens and sags and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, “filler fatigue” – when overuse of dermal fillers stretches the face and leads to looseness in the dermis – combined with the widespread use of slimming medications, low-cost surgical travel, and the advancement of new, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Statistics show an eight percent rise in facelifts over the past 12 months in the United Kingdom; while a survey revealed that the portion of youthful candidates is increasing, with one-third of procedures now performed on patients aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are evolving,” says Orfaniotis. Currently, the operation du jour is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a more traditional facelift involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling doctors to reshape the face by repositioning the deeper tissue, and avoiding the tight, stretched appearance occasionally caused by more traditional techniques. “We avoid placing stress on the dermis because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Elevating the entire soft tissue layer 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 “beautification” and contouring, too. “We’re getting 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 least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t do this because I desired to appear young,” she says. “I did it because the filler harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” states Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets slightly fluid-filled because its capacity to remove lymphatic fluid has been diminished.” Though studies into the topic is preliminary, cautionary statements on injectables’ possible effects on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would never use fillers in a client because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who make filler can be pretty aggressive.” He’s been told accounts, he adds, of plastic surgeons being landed with 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 – 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 facial and neck surgery could be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon advised her that a facelift was the right solution for the laxity she was finding in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, one day after she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ Thus I ultimately adding two more surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, plus a three-day|