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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday party. Not for the typical reasons related to a home packed of clamorous preteen kids, but since it’s the initial occasion she will debut her recently altered face to acquaintances and extended family. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not the way I appear,’” states the 30-year-old real estate agent from Southern Florida.

Her appearance is, admittedly, a little surprising – her face swollen and preternaturally lifted, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a doctor in Istanbul, Turkey, last month. “My spouse teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she tells me via online call from her home. “I had to tell him: ‘Babe, I’m okay, I’m not hurting. I just appear as if someone attacked me.’”

Growing Trend of Early Facelifts

Based on plastic surgeons, Preisinger is one of a rising count of people electing to have a rhytidectomy in their twenties and thirties – significantly before a decade prior to most doctors’ usual candidate age of forty to sixty. (Though many specialists are eager to highlight the industry edict of: “We address heredity, not age.”) “I have 28-year-olds requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a major surgery, and I’m a somewhat worried when I observe individuals choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the ligaments in the face that start to sag as we age. “Human faces are structured a bit like layers of an onion,” explains Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a stratum of supportive tissue known as the superficial musculoaponeurotic system. 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 down with it.”

You risk operating on individuals that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of affluent seniors, “filler fatigue” – when overuse of injectable gels expands the face and leads to looseness in the skin – combined with the common adoption of slimming medications, cut-price medical tourism, and the advancement of new, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. Reports indicate an eight percent rise in facial lifts over the last year in the UK; while a study revealed that the portion of younger facelift patients is growing, with one-third of procedures now conducted for individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the best version of themselves and obviously the techniques are following,” comments Orfaniotis. Currently, the operation du jour is the deep plane facelift, a technique promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails elevating the superficial layer, the comprehensive lift loosens the underlying structures beneath it, allowing doctors to restructure the face by moving the underlying layers, and preventing the tight, stretched appearance occasionally caused by more traditional techniques. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is no longer being used for the primary goal of anti-ageing – or revitalization, as the aesthetics industry terms it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “symmetry correction” meant that by the time she reached her late 20s, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she clarifies. “I did it because the injectable ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers ever fully dissolve has long been a point of contention in the aesthetics industry. “Research have shown that they seldom fully dissipate,” says Grover, “but they move and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although research into the topic is early-stage, warnings on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded face specialist, commenting on the condition of anonymity, says he would never use injectables in a patient because of the risks they pose. “A lot of surgeons avoid talk about this, because the manufacturers who make injectables can be pretty aggressive.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after raising their concerns.

Decision and Procedure

For Preisinger, once she started using injectables, she believed she needed to continue adding more – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery might be what she needed to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a list of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her surgeon recommended that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a cheek lift and a neck lift. The eve of her operation, 24 hours post she’d arrived solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|