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

Onemanda Preisinger feels anxious about her child’s impending 13th birthday party. Not for the typical causes associated with a home packed of clamorous preteen children, but since it’s the initial occasion she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to inform everyone as they arrive, ‘For your information, this is not how I appear,’” states the thirty-year-old property agent from Southern Florida.

Her appearance is, admittedly, a somewhat surprising – her face puffed up and unnaturally tightened, as though held together by industrial-grade tape. Her altered – and she’s keen to stress, short-term – look is the result of half a dozen aesthetic surgeries, including an minimally invasive facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My spouse became emotional when he saw me for the first time because I wasn’t able to even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her house. “I had to tell him: ‘Babe, 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 one of a growing number of individuals choosing to have a rhytidectomy in their 20s and 30s – significantly before a ten years prior to typical surgeons’ typical patient age range of 40 to 60. (Though many specialists are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds requesting facelifts,” states 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 individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, alternatively called a facelift, lifts the ligaments in the face that begin to droop as we age. “Our faces are built a little like layers of an onion,” says Kent-based facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a layer of supportive tissue known as the SMAS. Consider the facial framework as the soft tissue skeleton of the face. And that’s what ages us; that is what becomes lax and pulls the dermis downward with it.”

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

Previously reserved of moneyed older people, overuse of injectables – when overuse of injectable gels stretches the face and causes laxity in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, celebrity-endorsed surgical techniques are attracting a different type of customer towards this major operation. Reports show an 8% increase in facial lifts over the past 12 months in the UK; while a survey found that the portion of youthful candidates is growing, with one-third of procedures now performed on individuals aged 35-55.

“Patients 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 figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

Where a more traditional facelift entails elevating the superficial layer, the deep plane facelift releases the facial ligaments underneath, allowing doctors to restructure the face by repositioning the deeper tissue, and preventing the taut, pulled appearance sometimes wrought by older methods. “We’re not putting tension on the dermis because we’re targeting deeper, to the underlying structures,” explains Harley Street cosmetic doctor Rajiv Grover, who focuses on the advanced method. “It is the deeper tissue that is adjusted. The dermis comes with it as a passenger.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and more durable outcome. It also means that the surgery is not just being used for the primary goal of youth preservation – or revitalization, as the cosmetic field describes it – but for “beautification” and contouring, too. “We’re getting many inquiries from clients aged 28 to 35 for this reason,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facial lift – at minimum not at the thirty years old. But years of using injectable gels in an effort at “symmetry correction” implied that by the time she entered her late 20s, she was “damaged”. “I didn’t undergo this because I wanted to look youthful,” she says. “I did it because the injectable harmed my face. I wish I had never done it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”

If dermal fillers ever fully dissolve has historically been a debated topic in the aesthetics industry. “Studies have shown that not only do they rarely completely dissolve,” states Grover, “but they migrate and can obstruct lymphatic channels. A contributing factor to what we call ‘puffy appearance’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to drain bodily fluid has been reduced.” Though research into the topic is preliminary, warnings on dermal fillers’ potential impact on the lymphatic system have been released, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, mentioned he would never use fillers in a client because of the risks they pose. “A lot of doctors avoid discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he says, of cosmetic doctors facing court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue adding more – particularly when it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in the state suggested that a face and neck lift could be what she needed to exit the injectable hamster wheel. Two years later, she found herself selecting from a selection of suggested accommodations in Istanbul, texted to her by the patient coordinator at her doctor’s clinic.

Initially, Preisinger had scheduled an upper and lower blepharoplasty – commonly called blepharoplasty – but her doctor recommended that a facelift was the right solution for the laxity she was experiencing in her face. She booked a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d arrived solo in Turkey, she decided to add a lip lift. “Subsequently the surgeon stated, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will sculpt your face.’ So I ended up including additional surgeries,” she says. She paid $22,000 (sixteen thousand five hundred pounds) for the six-hour operation, including a three-day|