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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday party. It’s not due to the typical causes related to a house full of loud preteen kids, but since it’s the initial occasion she will showcase her recently altered face to acquaintances and extended family. “Obviously I’m going to tell all guests as they arrive, ‘Just so you know, this is not the way I look,’” says the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little startling – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her new – and she’s eager to emphasize, temporary – look is the outcome of half a dozen cosmetic procedures, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I had to tell him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Early Facelifts

Based on plastic surgeons, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their twenties and thirties – significantly before a decade before most doctors’ usual candidate age of forty to sixty. (Though most surgeons are keen to emphasise the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds asking for facial lifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people choosing it as a personal preference.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the tissues in the face that start to sag as we age. “Our faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue called the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that is what causes aging; that is what loosens and sags and drags the dermis down with it.”

You risk performing surgery on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when excessive use of dermal fillers expands the face and causes looseness in the dermis – alongside the common adoption of slimming medications, low-cost medical tourism, and the advancement of novel, celebrity-endorsed surgical techniques are attracting a new kind of patient towards this major operation. Statistics show an eight percent rise in facelifts over the last year in the United Kingdom; while a survey found that the percentage of younger facelift patients is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and naturally the techniques are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional rhytidectomy involves lifting the SMAS, the comprehensive lift releases the facial ligaments beneath it, allowing surgeons to reshape the face by moving the underlying layers, and avoiding the tight, stretched appearance occasionally caused by older methods. “We avoid placing stress on the skin because we’re going below, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable outcome. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” says 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 attempt at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look young,” she says. “I underwent it because the filler ruined my face. I regret ever done it. If I didn’t have the injectable, I don’t believe I would be in this situation currently.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” states Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its capacity to drain bodily fluid has been diminished.” Although research into the area is early-stage, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies initiated. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the risks they present. “A lot of doctors avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors facing legal actions after raising their concerns.

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 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 needed to finally step off the cycle of treatments. After 24 months, she found herself choosing between a list of recommended hotels in the city, sent to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the right solution for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her operation, 24 hours post she’d touched down solo in the country, she decided to add a mouth enhancement. “Then he stated, ‘We’re going to lift the lower eyelid puffiness.’ Then he said, ‘I think if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|