‘My Eyes Were So Puffy I Was Unable to Even Open Them’

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the usual reasons related to a house full of clamorous adolescent kids, but because it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a little surprising – her face puffed up and preternaturally lifted, as though held together by heavy-duty tape. Her new – and she’s keen to stress, temporary – look is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “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

According to cosmetic specialists, Preisinger is one of a rising count of people electing to undergo a facelift in their 20s and 30s – significantly before a ten years prior to most doctors’ typical patient age range of 40 to 60. (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,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Understanding the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, 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 facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and drags the skin downward with it.”

You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes laxity in the dermis – combined with the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted operative methods are driving a different type of customer towards this major operation. Reports indicate an eight percent rise in facial lifts over the past 12 months in the United Kingdom; while a survey revealed that the percentage of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and obviously the techniques are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

While a conventional rhytidectomy entails lifting the superficial layer, the deep plane facelift releases the underlying structures beneath it, allowing surgeons to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It additionally implies that the procedure is no longer being used for the primary goal of youth preservation – or rejuvenation, as the cosmetic field describes it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had not intended on getting a facelift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” implied that by the time she reached her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t believe I would be where I’m at currently.”

Whether injectable substances 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 obstruct drainage pathways. A contributing factor to what we term ‘puffy appearance’ is additionally the fact that to some extent, the face becomes somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Although research into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and further research initiated. One highly regarded face specialist, speaking on the condition of anonymity, mentioned he would avoid using injectables in a client because of the risks they present. “Many doctors don’t want to talk about this, because the companies who make filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning using injectables, she believed she had to keep adding more – especially as it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her doctor advised her 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 jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|