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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday celebration. Not for the usual reasons associated with a home packed of loud preteen kids, but because it’s the first time she will reveal her new face to acquaintances and extended family. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not the way I look,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s keen to stress, short-term – appearance is the outcome of six cosmetic procedures, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a rising count of people electing to undergo a facelift in their twenties and thirties – significantly before a decade before most doctors’ usual candidate age of 40 to 60. (Although many specialists are eager to highlight the industry edict of: “We treat genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, and I’m a somewhat worried when I observe individuals choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that begin to droop as we grow older. “Our faces are structured a little like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Think of 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 dermis down with it.”

You risk operating on people that have deeper issues. It’s not a practice for an conscientious surgeon to pursue

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels stretches the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of new, famous-figure-promoted operative methods are driving a new kind of patient towards this major operation. Reports indicate an eight percent rise in facelifts over the past 12 months in the UK; while a survey revealed that the percentage of youthful candidates is increasing, with 32% of facelifts now conducted for patients aged thirty-five to fifty-five.

“Patients are now requesting to look like the optimal form of themselves and obviously the techniques are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised 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 comprehensive lift releases the facial ligaments underneath, allowing surgeons to restructure the face by moving the deeper tissue, and avoiding the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is repositioned. The skin comes with it as a secondary element.” Elevating the whole facial structure as a single unit allows for a authentic-appearing and longer-lasting outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and contouring, too. “We’re getting numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Individual Experience

Preisinger had never planned on undergoing a facelift – at minimum not at the age of 30. But years of using hyaluronic acid dermal fillers in an attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the filler ruined my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has historically been a debated topic in the cosmetic field. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Although research into the area is early-stage, warnings on injectables’ possible effects on the lymphatic system have been released, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the risks they present. “A lot of doctors don’t want to talk about this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she had to keep adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a face and neck lift might be what she needed to exit the cycle of treatments. Two years later, she found herself selecting from a selection of recommended hotels in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Then he stated, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|