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

Onemanda Preisinger experiences worry about her child’s impending 13th birthday celebration. Not for the usual causes related to a home packed of clamorous adolescent kids, but since it’s the first time she will showcase her recently altered face to acquaintances and extended family. “Clearly I’m going to tell everyone as they arrive, ‘For your information, this is not how I appear,’” says the thirty-year-old property agent from Southern Florida.

How she looks is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, short-term – appearance 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 poor husband became emotional when he saw me for the first time because I couldn’t even unseal my eyes. That’s how puffy I was,” she explains to me via video call from her home. “I needed to inform him: ‘Babe, I’m fine, I’m not hurting. I just appear as if someone jumped me.’”

Increasing Popularity of Youthful Facial Lifts

According to cosmetic specialists, Preisinger is among a rising count of people choosing to undergo a rhytidectomy in their 20s and 30s – well over a decade before typical surgeons’ usual candidate age of forty to sixty. (Though most surgeons are eager to highlight the professional guideline of: “We treat genetics, not age.”) “I have 28-year-olds requesting facial lifts,” says London-based aesthetic plastic surgeon Georgios Orfaniotis, a former NHS consultant who focuses on the head and neck. “It’s a very significant surgery, and I’m a bit concerned when I see people opting for it as a personal preference.”

Explaining the Facelift Procedure

A facelift, alternatively called a facelift, elevates the ligaments in the face that begin to droop as we grow older. “Our faces are structured a bit like layers of an onion,” explains Kent-based facial plastic surgeon Marc Pacifico. “Skin and fat on the top, then a stratum of connective tissue known as the superficial musculoaponeurotic system. Consider the SMAS as the structural foundation of the face. And that is what causes aging; that’s what becomes lax and drags the skin down with it.”

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

Once the preserve of moneyed older people, “filler fatigue” – when overuse of dermal fillers expands the face and leads to laxity in the skin – alongside the widespread use of slimming medications, low-cost medical tourism, and the development of new, famous-figure-promoted operative methods are attracting a different type of patient towards this major operation. Reports show an 8% increase in facial lifts over the last year in the UK; while a study revealed that the portion of youthful candidates is growing, with one-third of procedures now conducted for individuals aged 35-55.

“Patients are now requesting to appear as the best version of themselves and naturally the techniques are following,” comments Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by everyone from reality TV star Kris Jenner, to fashion designer Marc Jacobs.

Deep Plane Technique

Where a conventional rhytidectomy involves elevating the SMAS, the deep plane facelift loosens the facial ligaments beneath it, enabling surgeons to restructure the face by moving the underlying layers, and avoiding the taut, pulled appearance sometimes wrought by more traditional techniques. “We avoid placing stress on the skin because we’re targeting deeper, to the deeper tissue,” says prestigious London cosmetic doctor Rajiv Grover, who focuses on the deep plane technique. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Elevating the entire soft tissue layer as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the express purpose of youth preservation – or revitalization, as the cosmetic field terms 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 never planned on getting a facial lift – at minimum 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 entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear youthful,” she clarifies. “I did it because the injectable harmed my face. I wish I had never using it. If I didn’t have the injectable, I don’t believe I would be where I’m at currently.”

If injectable substances completely disappear has historically been a debated topic in the aesthetics industry. “Research have shown that not only do they rarely completely dissolve,” says Grover, “but they migrate and can obstruct lymphatic channels. One of the contributors to what we call ‘puffy appearance’ is additionally the reality that to some extent, the face becomes somewhat fluid-filled because its capacity to remove bodily fluid has been reduced.” Though research into the topic is preliminary, warnings on injectables’ potential impact on the body’s drainage have been issued, and further research initiated. An esteemed face specialist, commenting on the condition of anonymity, says he would avoid using fillers in a client because of the risks they pose. “A lot of surgeons don’t want to discussing this, because the manufacturers who produce injectables can be pretty aggressive.” He’s been told accounts, he says, of plastic surgeons being landed with court orders after expressing worries.

Choice and Surgery

For Preisinger, once she started using injectables, she felt as if she needed to continue replenishing it – especially as it began moving to different areas of her face. She was only twenty-eight when a local plastic surgeon in Florida suggested that a facial and neck surgery might be what she required to exit the cycle of treatments. After 24 months, she ended up selecting from a list of suggested accommodations in Istanbul, texted to her by the patient coordinator at her surgeon’s office.

Initially, Preisinger had scheduled an eyelid surgery – better known as blepharoplasty – but her surgeon advised her that a facial lift was the right solution for the laxity she was experiencing in her face. She arranged a brow lift, a mid-facelift and a jawline surgery. The eve of her surgery, one day after she’d arrived alone in the country, she opted to include a lip lift. “Then he said, ‘We will lift the under-eye bags.’ Then he said, ‘I think if we extract some cheek fat, it will sculpt your face.’ So I ended up adding two more procedures,” she recalls. She paid $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|