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

Onemanda Preisinger is nervous about her child’s upcoming 13th birthday celebration. Not for the typical reasons related to a house full of clamorous preteen kids, but because it’s the first time she will reveal her recently altered face to acquaintances and extended family. “Clearly I’m going to inform everyone as they come in, ‘For your information, this is not how I look,’” says the 30-year-old property agent from south Florida.

How she looks is, admittedly, a somewhat startling – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a surgeon in Turkey’s Istanbul, last month. “My poor husband became emotional when he viewed me for the first time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via video call from her house. “I had to tell him: ‘Babe, I’m okay, I’m not in pain. I just appear as if someone attacked me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of people choosing to undergo a rhytidectomy in their twenties and thirties – well over a decade before typical surgeons’ usual candidate age of 40 to 60. (Though most surgeons are keen to emphasise the professional guideline of: “We treat heredity, not years.”) “I have 28-year-olds requesting facelifts,” says London-based cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant surgery, and I’m a somewhat worried when I observe people opting for it as a personal preference.”

Explaining the Facelift Procedure

A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we grow older. “Human faces are structured a little like onion layers,” explains Kent-based face specialist Marc Pacifico. “Dermis and adipose on the surface, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that is what causes aging; that’s what loosens and sags and pulls the dermis downward with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and causes looseness in the dermis – alongside the common adoption of slimming medications, low-cost surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are attracting a new kind of customer towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the UK; while a study found that the portion of younger facelift patients is increasing, with 32% of facelifts now conducted for individuals aged 35-55.

“Patients are now requesting to look like the optimal form of themselves and obviously the methods are evolving,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the superficial layer, the deep plane facelift releases the underlying structures beneath it, enabling doctors to restructure the face by repositioning 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 targeting deeper, to the underlying structures,” explains prestigious London cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The skin follows along as a secondary element.” Lifting the entire soft tissue layer as a single unit results in a more natural-looking and more durable result. It additionally implies that the procedure is not just being used for the primary goal of youth preservation – or revitalization, as the aesthetics industry describes it – but for “beautification” and contouring, too. “We’re getting numerous requests from clients aged late twenties to mid-thirties for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on getting a facial lift – at least not at the thirty years old. But long-term using injectable gels in an attempt at “symmetry correction” meant 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 did it because the filler ruined my face. I regret ever using it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

Whether dermal fillers completely disappear has long been a point of contention in the aesthetics industry. “Studies have shown that they seldom fully dissipate,” says Grover, “but they move and can block lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face gets somewhat fluid-filled because its capacity to remove lymphatic fluid has been reduced.” Although research into the area is preliminary, warnings on injectables’ possible effects on the body’s drainage have been issued, and further research announced. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would avoid using fillers in a client because of the risks they pose. “A lot of surgeons don’t want to talk about this, because the manufacturers who make injectables can be quite forceful.” He’s been told accounts, he says, of plastic surgeons facing court orders after raising their concerns.

Choice and Surgery

For Preisinger, once she started using injectables, she believed she needed to continue adding more – especially as it began moving to different areas of her face. She was only twenty-eight when a nearby cosmetic doctor in the state suggested that a face and neck lift could be what she required to finally step off the injectable hamster wheel. After 24 months, she found herself choosing between a list of recommended hotels in the city, 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 eyelid surgery – but her surgeon advised her that a facial lift was the correct option for the looseness she was finding in her face. She booked a brow lift, a mid-facelift and a jawline surgery. The day before her operation, one day after she’d touched down alone in the country, she decided to add a lip lift. “Then he said, ‘We’re going to lift the under-eye bags.’ Then he said, ‘I believe if we remove some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, plus a three-day|