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

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. It’s not due to the usual causes related to a home packed of clamorous adolescent children, 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 all guests as they come in, ‘Just so you know, this is not how I look,’” says the 30-year-old property agent from south Florida.

How she looks is, well, a little startling – her face puffed up and preternaturally lifted, as though held together 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 endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My spouse became emotional when he saw me for the initial time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via online call from her house. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is among a growing number of people electing to undergo a facelift in their 20s and 30s – significantly before a ten years before typical surgeons’ typical patient age range of 40 to 60. (Although many specialists are eager to highlight the professional guideline of: “We treat heredity, not age.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who specialises in the facial area. “It’s a major surgery, 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, lifts the tissues in the face that start to sag as we age. “Our faces are structured a bit like onion layers,” says based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, then a layer of connective tissue known as the superficial musculoaponeurotic system. Think of the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that’s what becomes lax and drags the skin down with it.”

You risk performing surgery on people that have deeper issues. It’s not advisable for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of dermal fillers expands the face and leads to laxity in the dermis – combined with the widespread use of weight-loss drugs, cut-price medical tourism, and the development of new, celebrity-endorsed surgical techniques are driving a different type of patient towards this major operation. Statistics indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a study revealed that the portion of younger facelift patients is growing, with 32% of facelifts now conducted for individuals aged thirty-five to fifty-five.

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

Deep Plane Technique

Where a conventional rhytidectomy entails elevating the SMAS, the deep plane facelift releases the underlying structures beneath it, enabling doctors to restructure the face by moving the underlying layers, and avoiding the taut, pulled look occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the underlying layers that is adjusted. The skin follows along as a secondary element.” Elevating the entire soft tissue layer as a single unit allows for a authentic-appearing and longer-lasting outcome. It additionally implies that the surgery is not just being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive numerous requests from patients aged late twenties to mid-thirties for this reason,” notes Grover.

Personal Journey

Preisinger had never planned on getting a facelift – at minimum not at the age of 30. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late 20s, she was “botched”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the injectable harmed my face. I wish I had never using it. If I didn’t have the filler, I don’t believe I would be in this situation currently.”

Whether dermal fillers completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that they seldom completely dissolve,” says Grover, “but they migrate and can obstruct drainage pathways. A contributing factor to what we term ‘pillow face’ is also the reality that in a sense, the face becomes somewhat waterlogged because its ability to drain bodily fluid has been reduced.” Although studies into the topic is early-stage, cautionary statements on injectables’ possible effects on the lymphatic system have been issued, and further research announced. One highly regarded face specialist, commenting anonymously, mentioned he would never use injectables in a client because of the dangers they present. “A lot of surgeons avoid discussing this, because the manufacturers who produce filler can be quite forceful.” He’s heard stories, he says, of plastic surgeons facing legal actions after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she needed to continue replenishing it – particularly when it started to migrate to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a facial and neck surgery might be what she required to exit the injectable hamster wheel. After 24 months, she ended up selecting from a selection of recommended hotels in Istanbul, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had scheduled an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facial lift was the right solution for the looseness she was experiencing in her face. She arranged a forehead lift, a cheek lift and a jawline surgery. The day before her operation, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Subsequently the surgeon stated, ‘We’re going to lift the lower eyelid puffiness.’ He added, ‘I think if we remove some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (£16,500) for the six-hour surgery, plus a three-day|