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

Onemanda Preisinger is nervous about her daughter’s upcoming 13th birthday celebration. It’s not due to the typical reasons related to a house full of loud preteen children, but since it’s the first time she will reveal her new face to friends and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” says the thirty-year-old real estate agent from south Florida.

How she looks is, well, a somewhat startling – her face swollen and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – look is the result of half a dozen cosmetic procedures, such as an minimally invasive facelift, conducted by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband teared up when he viewed me for the first time because I couldn’t even open my eyes. That’s how swollen I was,” she explains to me via online call from her home. “I had to tell him: ‘Honey, I’m okay, I’m not hurting. I just look like someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Although many specialists are eager to highlight the professional guideline of: “We address heredity, not years.”) “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 bit concerned 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 grow older. “Our faces are structured a little like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of connective tissue known as the SMAS. Consider the facial framework as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the skin down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of injectable gels stretches the face and causes looseness in the dermis – alongside the widespread use of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of customer towards this invasive surgery. Statistics show an eight percent rise in facial lifts over the last year in the UK; while a survey found that the percentage of youthful candidates is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“People are asking now to look like the best version of themselves and obviously the methods are following,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift involves elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling doctors to reshape the face by repositioning the underlying layers, and preventing the tight, stretched appearance sometimes wrought by more traditional techniques. “We’re not putting stress on the dermis because we’re going below, to the underlying structures,” says prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the whole facial structure as a single unit results in a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “enhancement” and facial restructuring, too. “We’re getting many inquiries from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Individual Experience

Preisinger had never planned on undergoing a facial lift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” 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 point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they move and can obstruct drainage pathways. One of the contributors to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face gets somewhat waterlogged because its capacity to remove bodily fluid has been diminished.” Though studies into the area is early-stage, cautionary statements on injectables’ possible effects on the body’s drainage have been released, and further research initiated. One highly regarded facial plastic surgeon, speaking on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “Many surgeons avoid discussing this, because the manufacturers who produce filler can be pretty aggressive.” He’s been told accounts, he says, of cosmetic doctors facing legal actions after expressing worries.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue replenishing it – particularly when it began moving to other parts of her face. She was just 28 when a local plastic surgeon in the state suggested that a face and neck lift could be what she required to exit the injectable hamster wheel. Two years later, she found herself selecting from a list of suggested accommodations in the city, texted to her by the clinic assistant at her doctor’s clinic.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a mid-facelift and a neck lift. The eve of her surgery, 24 hours post she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We will elevate the lower eyelid puffiness.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (£16,500) for the six-hour operation, including a three-day|