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

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday celebration. Not for the usual causes related to a house full of loud preteen kids, 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 all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old real estate agent from Southern Florida.

How she looks is, well, a little surprising – her face puffed up and unnaturally tightened, as though held together by heavy-duty tape. Her new – and she’s eager to emphasize, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband became emotional when he saw me for the initial time because I couldn’t even unseal my eyes. That’s how swollen I was,” she tells me via video call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade before typical surgeons’ typical patient age range of forty to sixty. (Although many specialists are keen to emphasise the professional guideline of: “We treat heredity, not age.”) “I have individuals in their late twenties requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are structured a bit like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the top, then a layer of connective tissue known as the SMAS. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and drags the dermis down with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and leads to laxity in the skin – alongside the common adoption of weight-loss drugs, cut-price 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 last year in the UK; while a study revealed that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to look like the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves elevating the superficial layer, the comprehensive lift releases the facial ligaments beneath it, allowing doctors to reshape the face by moving the deeper tissue, and preventing the tight, stretched look occasionally caused by more traditional techniques. “We’re not putting tension on the skin because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block allows for a authentic-appearing and longer-lasting result. It also means that the procedure is no longer being used for the express purpose of youth preservation – or revitalization, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive numerous requests from clients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “botched”. “I didn’t do this because I wanted to look youthful,” she says. “I underwent it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a debated topic in the cosmetic field. “Research have indicated that they seldom completely dissolve,” states Grover, “but they move and can block lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that to some extent, the face gets somewhat waterlogged because its ability to drain lymphatic fluid has been diminished.” Though studies into the area is early-stage, cautionary statements on dermal fillers’ potential impact on the lymphatic system have been issued, and further research initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use fillers in a patient because of the risks they present. “Many surgeons don’t want to talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she felt as if she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a facial and neck surgery might be what she needed to exit the cycle of treatments. After 24 months, she found herself choosing between a selection of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the looseness she was experiencing in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to elevate the lower eyelid puffiness.’ Then he said, ‘I believe 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 operation, including a three-day|