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

Onemanda Preisinger is nervous about her daughter’s impending 13th birthday celebration. Not for the usual reasons related to a home packed of loud adolescent kids, but since it’s the initial occasion she will debut her recently altered face to friends and relatives. “Obviously I’m going to tell everyone as they come in, ‘Just so you know, this is not the way I look,’” states the 30-year-old property agent from Southern Florida.

How she looks is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the result of six aesthetic surgeries, including an endoscopic mid-facelift, performed by a doctor in Istanbul, Turkey, last month. “My spouse became emotional when he viewed me for the initial time because I wasn’t able to even unseal my eyes. That indicates swollen I was,” she tells me via online call from her house. “I had to tell him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Growing Trend of Early Facelifts

According to plastic surgeons, Preisinger is among a rising count of individuals electing to undergo a facelift in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Although most surgeons are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the head and neck. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we age. “Human faces are built a bit like layers of an onion,” says based in Kent face specialist Marc Pacifico. “Dermis and adipose 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 drags the dermis down with it.”

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

Once the preserve of moneyed older people, overuse of injectables – when excessive use of injectable gels stretches the face and leads to laxity in the dermis – alongside the common adoption of weight-loss drugs, low-cost medical tourism, and the advancement of novel, celebrity-endorsed operative methods are attracting a new kind of customer towards this invasive surgery. Reports indicate an eight percent rise in facial lifts over the past 12 months in the UK; while a survey found that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for patients aged 35-55.

“Patients are asking now to appear as the optimal form of themselves and naturally the methods are evolving,” comments Orfaniotis. At present, the operation du jour is the comprehensive facial lift, a method promoted by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a more traditional rhytidectomy involves elevating the SMAS, the deep plane facelift releases the facial ligaments underneath, enabling doctors to restructure the face by moving the deeper tissue, and preventing the tight, stretched appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re targeting deeper, to the underlying structures,” says Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a passenger.” Lifting the entire soft tissue layer as a unified block results in a authentic-appearing and more durable outcome. It also means that the procedure is not just being used for the express purpose of anti-ageing – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and contouring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this purpose,” notes Grover.

Individual Experience

Preisinger had not intended on getting a facial lift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” meant that by the time she reached her late twenties, she was “damaged”. “I didn’t do this because I desired to appear youthful,” she says. “I did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

Whether injectable substances completely disappear has long been a debated topic in the aesthetics industry. “Studies have indicated that not only do they rarely fully dissipate,” says Grover, “but they migrate and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face becomes somewhat waterlogged because its ability to drain lymphatic fluid has been diminished.” Though studies into the topic is preliminary, warnings on injectables’ possible effects on the lymphatic system have been issued, and additional studies initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would avoid using injectables in a patient because of the risks they pose. “Many doctors don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s heard stories, he adds, of plastic surgeons being landed with legal actions after raising their concerns.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a facial and neck surgery could be what she required to exit the injectable hamster wheel. After 24 months, she found herself choosing between a selection of recommended hotels in Istanbul, texted to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as blepharoplasty – but her surgeon recommended that a facial lift was the correct option 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 alone in the country, she decided to add a lip lift. “Then he said, ‘We’re going to elevate the under-eye bags.’ He added, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day operation, plus a three-day|