‘My Eyes Were So Puffy I Couldn’t Even Open Them’

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes associated with a house full of loud adolescent kids, but since it’s the first time she will reveal her new face to friends and extended family. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not the way I appear,’” states the thirty-year-old property agent from south Florida.

How she looks is, well, a little surprising – her face swollen and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s eager to emphasize, short-term – look is the result of half a dozen aesthetic surgeries, such as an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the first time because I wasn’t able to even open my eyes. That indicates puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m fine, 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 rising count of people electing to have a facelift in their 20s and 30s – significantly before a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” says based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe people choosing it as a lifestyle choice.”

Understanding the Facelift Procedure

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are built a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue called the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that’s what ages us; that is what becomes lax and pulls the skin down with it.”

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

Once the preserve of affluent seniors, “filler fatigue” – when overuse of dermal fillers expands the face and leads to looseness in the dermis – combined with the common adoption of weight-loss drugs, low-cost surgical travel, and the development of new, famous-figure-promoted operative methods are attracting a new kind of customer towards this invasive surgery. Statistics indicate an eight percent rise in facelifts over the last year in the United Kingdom; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on individuals aged 35-55.

“People are now requesting to appear as the best version of themselves and obviously the techniques are following,” says Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method promoted by everyone from reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional facelift entails lifting the SMAS, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to restructure the face by repositioning the deeper tissue, and avoiding the taut, pulled appearance occasionally caused by older methods. “We’re not putting tension on the skin because we’re targeting deeper, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The dermis comes with it as a passenger.” Elevating the whole facial structure as a single unit results in a more natural-looking and more durable result. It also means that the procedure is no longer being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry terms it – but for “beautification” and contouring, too. “We receive many inquiries from clients aged 28 to 35 for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” meant that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I did it because the filler harmed my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be in this situation currently.”

If dermal fillers ever fully dissolve has historically been a debated topic in the cosmetic field. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they move and can block drainage pathways. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that in a sense, the face gets slightly waterlogged because its capacity to remove lymphatic fluid has been reduced.” Though studies into the topic is early-stage, cautionary statements on injectables’ potential impact on the lymphatic system have been released, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use injectables in a client because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing court orders after raising their concerns.

Decision and Procedure

For Preisinger, once she started injecting filler, she believed she needed to continue adding more – 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 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 Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Originally, Preisinger had scheduled an eyelid surgery – better known as eyelid surgery – but her doctor recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d touched down solo in Turkey, she opted to include a lip lift. “Subsequently the surgeon stated, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she recalls. She paid $22,000 (£16,500) for the half-day surgery, including a three-day|