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

Onemanda Preisinger experiences worry about her daughter’s impending 13th birthday party. It’s not due to the typical causes related to a house full of clamorous preteen kids, but since it’s the first time she will showcase her new face to friends and relatives. “Clearly I’m going to tell everyone as they arrive, ‘Just so you know, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

Her appearance is, well, a little startling – her face puffed up and preternaturally lifted, as though held together by industrial-grade tape. Her new – and she’s keen to stress, short-term – look is the result of six cosmetic procedures, including an minimally invasive facelift, performed by a surgeon in Turkey’s Istanbul, the previous month. “My poor husband became emotional 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 needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to have a rhytidectomy in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Although most surgeons are keen to emphasise the professional guideline of: “We address genetics, not age.”) “I have individuals in their late twenties requesting facelifts,” states London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a major procedure, and I’m a somewhat worried when I see individuals opting for it as a personal preference.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a rhytidectomy, lifts the tissues in the face that start to sag as we grow older. “Our faces are structured a bit like layers of an onion,” explains 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 is what ages us; that is what loosens and sags and pulls the dermis downward with it.”

You risk operating on individuals that have underlying problems. It’s not a practice for an conscientious surgeon to pursue

Once the preserve of affluent seniors, “filler fatigue” – when excessive use of injectable gels stretches the face and causes looseness in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of novel, famous-figure-promoted surgical techniques are driving a different type of patient towards this invasive surgery. Reports show an 8% increase in facelifts over the past 12 months in the United Kingdom; while a study revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged 35-55.

“Patients are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by figures including Kardashian matriarch Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

While a conventional facelift involves elevating the SMAS, the deep plane facelift loosens the underlying structures underneath, enabling doctors to restructure the face by moving the underlying layers, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting stress on the dermis because we’re going below, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Lifting the whole facial structure as a single unit allows for a authentic-appearing and more durable result. It also means that the procedure is not just being used for the express purpose of youth preservation – or rejuvenation, as the aesthetics industry terms it – but for “enhancement” and facial restructuring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she reached her late twenties, she was “botched”. “I didn’t undergo this because I wanted to look youthful,” she clarifies. “I underwent it because the filler harmed my face. I regret ever done it. If I had avoided the filler, I don’t believe I would be in this situation currently.”

If dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom completely dissolve,” says Grover, “but they migrate and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the fact that in a sense, the face becomes slightly waterlogged because its ability to drain bodily fluid has been reduced.” Although research into the area is preliminary, cautionary statements on dermal fillers’ possible effects on the lymphatic system have been issued, and further research announced. An esteemed facial plastic surgeon, commenting on the condition of anonymity, says he would never use injectables in a client because of the dangers they present. “Many doctors avoid talk about this, because the companies who make injectables can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started injecting filler, she felt as if she had to keep adding more – particularly when it started to migrate to different areas of her face. She was just 28 when a nearby cosmetic doctor in the state proposed that a facial and neck surgery could be what she needed to finally step off the injectable hamster wheel. Two years later, she ended up choosing between a selection of recommended hotels in the city, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facial lift was the right solution for the laxity she was finding in her face. She booked a brow lift, a cheek lift and a neck lift. The eve of her operation, one day after she’d arrived solo in the country, she decided to add a mouth enhancement. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I think if we extract some buccal fat, it will contour your face.’ So I ended up including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|