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

Onemanda Preisinger experiences worry about her child’s upcoming 13th birthday celebration. It’s not due to the usual causes associated with a house full of clamorous adolescent children, but because it’s the initial occasion she will debut her new face to acquaintances and relatives. “Clearly I’m going to inform all guests as they come in, ‘Just so you know, this is not the way I look,’” states the thirty-year-old real estate agent from south Florida.

Her appearance is, admittedly, a little startling – her face swollen and preternaturally lifted, as though held together by heavy-duty tape. Her altered – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, including an endoscopic mid-facelift, conducted by a surgeon in Istanbul, Turkey, the previous month. “My poor husband teared up when he saw me for the initial time because I couldn’t even unseal my eyes. That indicates puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m fine, I’m not hurting. I just look like someone jumped me.’”

Growing Trend of Youthful Facial Lifts

Based on cosmetic specialists, Preisinger is one of a growing number of people choosing to undergo a facelift in their 20s and 30s – well over a decade before typical surgeons’ typical patient age range of 40 to 60. (Although most surgeons are eager to highlight the professional guideline of: “We address heredity, not years.”) “I have individuals in their late twenties asking for facelifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a ex-NHS doctor who focuses on the facial area. “It’s a very significant procedure, and I’m a bit concerned when I observe individuals choosing it as a lifestyle choice.”

Explaining the Rhytidectomy Surgery

A rhytidectomy, also known as a rhytidectomy, elevates the ligaments in the face that start to sag as we grow older. “Our faces are built a little like layers of an onion,” explains based in Kent facial plastic surgeon Marc Pacifico. “Skin and fat on the surface, 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 causes aging; that is what becomes lax and pulls the dermis downward with it.”

You endanger operating on people that have deeper issues. It’s not a practice for an ethical plastic surgeon to follow

Once the preserve of moneyed older people, “filler fatigue” – when excessive use of injectable gels stretches the face and causes laxity in the dermis – combined with the common adoption of weight-loss drugs, cut-price medical tourism, and the advancement of novel, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. Statistics show an 8% increase in facial lifts over the past 12 months in the UK; while a survey revealed that the portion of younger facelift patients is increasing, with 32% of facelifts now performed on patients aged thirty-five to fifty-five.

“People are now requesting to appear as the optimal form of themselves and obviously the methods are evolving,” comments Orfaniotis. Currently, the trending procedure is the comprehensive facial lift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Advanced Lifting Method

While a more traditional rhytidectomy involves lifting the superficial layer, the comprehensive lift releases the facial ligaments underneath, allowing doctors to reshape the face by repositioning the underlying layers, and preventing the taut, pulled look occasionally caused by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” says Harley Street plastic surgeon Rajiv Grover, who specialises in the deep plane technique. “It is the underlying layers that is adjusted. The skin comes with it as a secondary element.” Elevating the entire soft tissue layer as a single unit results in a more natural-looking and more durable outcome. It also means that the procedure is no longer being used for the express purpose of anti-ageing – or revitalization, as the cosmetic field describes it – but for “beautification” and facial restructuring, too. “We receive many inquiries from patients aged late twenties to mid-thirties for this reason,” says Grover.

Individual Experience

Preisinger had not intended on undergoing a facial lift – at least not at the thirty years old. But long-term using hyaluronic acid dermal fillers in an attempt at “facial balancing” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I wanted to look young,” she clarifies. “I underwent it because the filler ruined my face. I wish I had never done it. If I had avoided the injectable, I don’t think I would be where I’m at right now.”

If injectable substances completely disappear has long been a debated topic in the cosmetic field. “Studies have shown that they seldom fully dissipate,” states Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘pillow face’ is also the reality that to some extent, the face becomes slightly waterlogged because its capacity to remove bodily fluid has been reduced.” Although studies into the area is preliminary, warnings on dermal fillers’ possible effects on the body’s drainage have been issued, and additional studies announced. One highly regarded facial plastic surgeon, commenting on the condition of anonymity, says he would never use fillers in a client because of the risks they pose. “A lot of doctors avoid talk about this, because the manufacturers who produce injectables can be pretty aggressive.” He’s heard stories, he says, of plastic surgeons being landed with 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 – 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 required to finally step off the injectable hamster wheel. After 24 months, she ended up selecting from a selection of suggested accommodations in the city, sent to her by the clinic assistant at her surgeon’s office.

Originally, Preisinger had planned for an upper and lower blepharoplasty – commonly called eyelid surgery – but her doctor recommended that a facial lift was the correct option for the looseness she was experiencing in her face. She arranged a forehead lift, a mid-facelift and a jawline surgery. The eve of her operation, 24 hours post she’d touched down alone in the country, she decided to add a mouth enhancement. “Then he said, ‘We will elevate the lower eyelid puffiness.’ He added, ‘I believe if we extract some cheek fat, it will contour your face.’ So I ended up including additional procedures,” she says. She paid $22,000 (£16,500) for the half-day operation, including a three-day|