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

Onemanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. Not for the usual reasons associated with a house full of clamorous adolescent kids, but because it’s the first time she will debut her recently altered face to acquaintances and relatives. “Obviously I’m going to tell all guests as they come in, ‘Just so you know, this is not how I appear,’” says the 30-year-old real estate agent from Southern Florida.

Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her new – and she’s eager to emphasize, short-term – appearance is the outcome of six aesthetic surgeries, such as an endoscopic mid-facelift, conducted by a doctor in Istanbul, Turkey, last month. “My poor husband teared up when he saw me for the initial time because I wasn’t able to even open my eyes. That’s how puffy I was,” she tells me via online call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone attacked me.’”

Growing Trend of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is one of a rising count of individuals choosing to have a facelift in their 20s and 30s – significantly before a decade prior to most doctors’ typical patient age range of 40 to 60. (Although many specialists are keen to emphasise the industry edict of: “We address genetics, not age.”) “I have 28-year-olds asking for facelifts,” says based in London 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 see people opting for it as a lifestyle choice.”

Understanding the Rhytidectomy Surgery

A facelift, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Our faces are structured a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the top, then a stratum of connective tissue known as the SMAS. Think of the SMAS as the structural foundation of the face. And that’s what ages us; that’s what loosens and sags and pulls the skin downward with it.”

You endanger performing surgery on people that have deeper issues. It’s not a practice for an conscientious surgeon to follow

Previously reserved of affluent seniors, overuse of injectables – when excessive use of injectable gels expands the face and leads to looseness in the dermis – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted surgical techniques are attracting a different type of patient towards this major operation. Reports show an eight percent rise in facelifts over the last year in the UK; while a study found that the percentage of younger facelift patients is growing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to look like the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the operation du jour is the deep plane facelift, a technique evangelised by figures including reality TV star Kris Jenner, to style creator Marc Jacobs.

Deep Plane Technique

While a more traditional rhytidectomy entails lifting the SMAS, the comprehensive lift loosens the underlying structures underneath, enabling surgeons to reshape the face by repositioning the deeper tissue, and preventing the taut, pulled look sometimes wrought by older methods. “We avoid placing tension on the dermis because we’re going below, to the deeper tissue,” explains Harley Street plastic surgeon Rajiv Grover, who focuses on the deep plane technique. “It is the deeper tissue that is adjusted. The skin follows along as a passenger.” Lifting the entire soft tissue layer as a single unit allows for a more natural-looking and longer-lasting outcome. It also means that the surgery is not just being used for the express purpose of anti-ageing – or revitalization, as the aesthetics industry describes it – but for “beautification” and facial restructuring, too. “We’re getting many inquiries from patients aged 28 to 35 for this purpose,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facelift – at least not at the age of 30. But years of using injectable gels in an attempt at “facial balancing” meant that by the time she entered her late twenties, she was “damaged”. “I didn’t do this because I wanted to look youthful,” she says. “I did it because the injectable ruined my face. I regret ever using it. If I didn’t have the filler, I don’t think I would be in this situation currently.”

Whether injectable substances ever fully dissolve has long been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” states Grover, “but they migrate and can block drainage pathways. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that to some extent, the face gets slightly waterlogged because its capacity to drain bodily fluid has been reduced.” Though research into the topic is early-stage, warnings on injectables’ potential impact on the body’s drainage have been issued, and additional studies initiated. An esteemed facial plastic surgeon, speaking anonymously, mentioned he would never use injectables in a patient because of the risks they pose. “Many surgeons don’t want to discussing this, because the companies who produce injectables can be quite forceful.” He’s been told accounts, he adds, of plastic surgeons facing legal actions after raising their concerns.

Decision and Procedure

For Preisinger, after beginning injecting filler, she believed she needed to continue adding more – particularly when it began moving to different areas of her face. She was just 28 when a nearby cosmetic doctor in Florida proposed that a face and neck lift might be what she needed to finally step off the cycle of treatments. Two years later, she ended up selecting from a list of recommended hotels in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Originally, Preisinger had scheduled an eyelid surgery – commonly called blepharoplasty – but her surgeon recommended that a facelift was the right solution for the looseness she was finding in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her operation, 24 hours post she’d arrived alone in Turkey, she decided to add a lip lift. “Subsequently the surgeon said, ‘We’re going to lift the under-eye bags.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ Thus I ultimately including additional surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the six-hour surgery, including a three-day|