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

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a home packed of clamorous adolescent kids, but because it’s the first time she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell all guests as they arrive, ‘For your information, this is not the way I appear,’” says the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a somewhat startling – her face swollen and unnaturally tightened, as though held together by heavy-duty tape. Her altered – and she’s eager to emphasize, short-term – look is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she explains to me via video call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people electing to have a rhytidectomy in their twenties and thirties – well over a decade 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 aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A facelift, also known as a rhytidectomy, elevates the ligaments in the face that begin to droop as we age. “Our faces are built a little like onion layers,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers expands the face and causes looseness in the dermis – combined with the widespread use of slimming medications, cut-price medical tourism, and the development of new, famous-figure-promoted operative methods are driving a different type of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“People are now requesting to appear as the best version of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to restructure the face by moving the deeper tissue, and preventing the taut, pulled look sometimes wrought by older methods. “We’re not putting stress on the skin because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But long-term using injectable gels in an effort at “facial balancing” meant that by the time she reached her late 20s, she was “botched”. “I didn’t do this because I desired to appear young,” she says. “I underwent it because the filler harmed my face. I wish I had never done it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have shown that not only do they rarely fully dissipate,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat waterlogged because its capacity to drain bodily fluid has been reduced.” Though studies into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been released, and additional studies initiated. An esteemed facial plastic surgeon, speaking on the condition of anonymity, mentioned he would avoid using fillers in a patient because of the risks they pose. “Many doctors don’t want to talk about this, because the manufacturers who produce filler can be pretty aggressive.” He’s heard stories, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – particularly when it began moving to different areas of her face. She was just 28 when a local plastic surgeon in Florida proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. After 24 months, she found herself selecting from a list of recommended hotels in the city, texted to her by the clinic assistant at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facelift was the right solution 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 arrived alone in Turkey, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up including additional procedures,” she recalls. She spent $22,000 (£16,500) for the half-day operation, including a three-day|