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

Onemanda Preisinger feels anxious about her daughter’s upcoming 13th birthday party. It’s not due to the typical reasons associated with a house full of loud adolescent children, but because it’s the first time she will reveal her recently altered face to acquaintances and relatives. “Clearly I’m going to tell everyone as they come in, ‘For your information, this is not how I appear,’” states the thirty-year-old property agent from south Florida.

How she looks is, admittedly, a little surprising – her face puffed up and preternaturally lifted, as though secured by heavy-duty tape. Her altered – and she’s keen to stress, short-term – appearance is the outcome of half a dozen aesthetic surgeries, including an minimally invasive facelift, conducted by a surgeon in Istanbul, Turkey, 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 swollen I was,” she tells me via online call from her home. “I needed to inform him: ‘Babe, I’m okay, I’m not in pain. I just look like someone jumped me.’”

Increasing Popularity of Early Facelifts

According to plastic surgeons, Preisinger is one of a growing number of individuals choosing to undergo a facelift in their twenties and thirties – significantly before a decade before typical surgeons’ usual candidate age of 40 to 60. (Although many specialists are keen to emphasise the professional guideline of: “We address genetics, not years.”) “I have 28-year-olds requesting facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the head and neck. “It’s a very significant procedure, and I’m a somewhat worried when I observe people opting for it as a lifestyle choice.”

Understanding the Facelift Procedure

A rhytidectomy, also known as a facelift, lifts the ligaments in the face that start to sag as we age. “Human faces are built a bit like layers of an onion,” says based in Kent facial plastic surgeon Marc Pacifico. “Dermis and adipose on the surface, then a stratum of connective tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that is what loosens and sags and drags the dermis downward with it.”

You endanger performing surgery on people that have underlying problems. It’s not a practice for an ethical plastic surgeon to follow

Previously reserved of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and leads to looseness in the skin – combined with the widespread use of weight-loss drugs, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a different type of patient towards this invasive surgery. Reports show an 8% increase in facial lifts over the last year in the UK; while a study found that the percentage of youthful candidates is growing, with one-third of procedures now performed on individuals aged thirty-five to fifty-five.

“Patients are asking now to appear as the optimal form of themselves and obviously the techniques are evolving,” comments Orfaniotis. At present, the trending procedure is the comprehensive facial lift, a technique evangelised by everyone from Kardashian matriarch Kris Jenner, to style creator Marc Jacobs.

Advanced Lifting Method

Where a conventional facelift involves elevating the SMAS, the deep plane facelift releases the facial ligaments beneath it, allowing doctors to reshape the face by moving the underlying layers, and preventing the taut, pulled appearance occasionally caused by older methods. “We avoid placing tension on the skin because we’re going below, to the deeper tissue,” says Harley Street cosmetic doctor Rajiv Grover, who specialises in the advanced method. “It is the deeper tissue that is adjusted. The dermis follows along as a passenger.” Elevating the whole facial structure as a single unit results in a authentic-appearing and longer-lasting result. It also means that the surgery is no longer being used for the express purpose of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “enhancement” and facial restructuring, too. “We’re getting numerous requests from clients aged 28 to 35 for this purpose,” says Grover.

Personal Journey

Preisinger had never planned on undergoing a facelift – at least not at the age of 30. But long-term using hyaluronic acid dermal fillers in an effort at “facial balancing” 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 underwent it because the injectable harmed my face. I regret ever using it. If I didn’t have the injectable, I don’t believe I would be in this situation right now.”

Whether dermal fillers completely disappear has historically been a debated topic in the aesthetics industry. “Research have indicated that they seldom completely dissolve,” says Grover, “but they move and can block lymphatic channels. One of the contributors to what we term ‘puffy appearance’ is additionally the reality that in a sense, the face gets somewhat waterlogged because its capacity to drain lymphatic fluid has been diminished.” Though studies into the area is early-stage, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and further research initiated. One highly regarded face specialist, commenting on the condition of anonymity, mentioned he would never use fillers in a patient because of the risks they pose. “A lot of doctors don’t want to discussing this, because the manufacturers who make filler can be quite forceful.” He’s been told accounts, he adds, of cosmetic doctors being landed with legal actions after expressing worries.

Choice and Surgery

For Preisinger, after beginning injecting filler, she felt as if she needed to continue adding more – especially as it started to migrate to other parts of her face. She was only twenty-eight when a local plastic surgeon in Florida proposed that a facial and neck surgery could be what she needed to exit the injectable hamster wheel. Two years later, she ended up choosing between a list of recommended hotels in Istanbul, sent to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her doctor advised her that a facial lift was the correct option for the laxity she was finding in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The day before her surgery, one day after she’d touched down solo in the country, she decided to add a lip lift. “Then he said, ‘We will lift the lower eyelid puffiness.’ He added, ‘I believe if we remove some buccal fat, it will contour your face.’ So I ended up including additional procedures,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, plus a three-day|