‘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 typical causes associated with a home packed of clamorous preteen kids, but because it’s the first time she will debut her recently altered face to friends and relatives. “Clearly I’m going to inform all guests as they come in, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a little startling – her face swollen and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is among a rising count of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade before most doctors’ typical patient age range of forty to sixty. (Though most surgeons are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I see people opting for it as a lifestyle choice.”

Explaining the Facelift Procedure

A facelift, also known as a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like layers of an onion,” explains based in Kent face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Consider the SMAS as the structural foundation of the face. And that’s what causes aging; that’s what becomes lax and pulls the skin downward with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an ethical plastic surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of dermal fillers stretches the face and causes looseness in the dermis – alongside the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, celebrity-endorsed surgical techniques are attracting a new kind of customer towards this major operation. Reports show an eight percent rise in facelifts over the last year in the UK; while a study found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“Patients are now requesting to appear as the best version of themselves and naturally the methods are evolving,” comments Orfaniotis. Currently, the operation du jour is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, enabling surgeons to reshape the face by moving the deeper tissue, and avoiding the tight, stretched 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 plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The dermis follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It also means that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “symmetry correction” implied that by the time she entered her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she says. “I underwent it because the filler harmed my face. I regret ever done it. If I had avoided the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has historically been a debated topic in the cosmetic field. “Research have shown that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we term ‘puffy appearance’ is also the reality that in a sense, the face gets somewhat waterlogged because its ability to remove bodily fluid has been reduced.” Although studies into the area is early-stage, warnings on dermal fillers’ potential impact 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 fillers in a patient because of the dangers they pose. “Many doctors avoid discussing this, because the companies who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she had to keep replenishing it – especially as it began moving to other parts of her face. She was only twenty-eight when a nearby cosmetic doctor in the state proposed that a face and neck lift could be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her surgeon advised her that a facelift was the correct option for the looseness she was finding in her face. She arranged a brow lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d arrived solo in the country, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will elevate the under-eye bags.’ He added, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day operation, including a three-day|